Individual
THOMAS M. CLEMENTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-9729
(706) 721-8507
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2602
(706) 828-6410
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003674
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0113PA
—
SC
05
—
100002065A
—
GA
Enumeration date
08/30/2006
Last updated
03/31/2011
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