Organization Name: | THOMASTON EAR, NOSE AND THROAT INC. |
NPI Number: | 1417958786 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN ANTHONY O'CONNELL (PHYSICIAN/PRESIDENT) |
Mailing Address: | 210 Cherokee Rd Thomaston |
State: | GA US |
Postal Code: | 302863402 |
Phone Number: | 7066464508 |
Fax Number: | 7066462752 |
NPI Enumeration Date: | 08/09/2005 |
NPI Last Update Date: | 04/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 041918 |
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. |