Organization
DR. EDDIE D. THOMAS, M.D.,P.C.
Active
Other names
Dr. Eddie D. Thomas, M.D.,P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
KANDIE R MEDLOCK (OFFICE MANAGER)
(912) 530-7337
Entity
Organization
Contact information
Practice address
391 PEACHTREE ST, JESUP, GA 31545-0245
(912) 530-7337
(912) 530-7339
Mailing address
391 PEACHTREE ST, JESUP, GA 31545-0245
(912) 530-7337
(912) 530-7339
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
053192
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10059181
AMERIGROUP
GA
01
—
342408
WELLCARE
GA
05
—
798956032A
—
GA
Enumeration date
09/22/2017
Last updated
07/21/2022
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