Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 033896 | GA |
NPI | 1013005149 |
---|---|
Provider Name | Dr. Pankajkumar Narayanbhai Thakkar |
First Address | Evans, GA 30809-3844 |
Second Address | Augusta, GA 30904-6258 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 08/07/2007 |