Individual
THOMAS L TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2064 VINEVILLE AVE, MACON, GA 31204-3140
(478) 743-1478
(478) 746-8536
Mailing address
2064 VINEVILLE AVE, MACON, GA 31204-3140
(478) 743-1478
(478) 746-8536
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
022897
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00237212
—
GA
Enumeration date
05/11/2006
Last updated
06/29/2010
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