Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | 034485 | GA |
NPI | 1316928823 |
---|---|
Provider Name | Dr. James Thomsen |
First Address | Atlanta, GA 30342-3009 |
Second Address | Atlanta, GA 30342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2005 |
Last Update Date | 25/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00476473A | (05) | GA |
BT1881843 | DEA (01) | GA |
E72177 | (02) | GA |