Doctor Name: | THOMAS ALLEN |
NPI Number: | 1780795484 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 010018 |
Business Practice Address: | 420 Johnson St Se Dawson, GA - 398421523 |
Business Phone Number: | 2299952990 |
Business Fax Number: | 2299952993 |
Mailing Address: | 204 N Westover Blvd, ALBANY |
State: | GA |
Postal Code: | 317072983 |
Phone Number: | 2298886559 |
Fax Number: | 2294364107 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 010018 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |