Individual
DR. JACQUES C THAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 N BROAD ST NE STE 140, ROME, GA 30161-5202
(706) 291-2661
(706) 784-4375
Mailing address
901 N BROAD ST NE STE 140, ROME, GA 30161-5202
(706) 291-2661
(706) 784-4375
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
100115
GA
2085R0204X
Vascular & Interventional Radiology Physician
51388020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002520205
MEDICARE PTAN
WI
05
—
35328400
—
WI
Enumeration date
06/17/2008
Last updated
08/05/2026
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