Doctor Name: | PHOEBE GATES THORPE |
NPI Number: | 1003814369 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D., M.P.H. |
License Number: | 53889 |
Business Practice Address: | 5405 Memorial Dr Suite D Stone Mountain, GA - 300833234 |
Business Phone Number: | 4042963800 |
Business Fax Number: | 4042978753 |
Mailing Address: | 5405 Memorial Dr Ste D, STONE MOUNTAIN |
State: | GA |
Postal Code: | 300833236 |
Phone Number: | 4042963800 |
Fax Number: | 4042978753 |
NPI Enumeration Date: | 07/12/2005 |
NPI Last Update Date: | 04/20/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 53889 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |