Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 036304 | GA |
NPI | 1003843749 |
---|---|
Provider Name | James Patrick Thomson |
First Address | Fort Lauderdale, FL 33355-1420 |
Second Address | Decatur, GA 30033-5918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 20/02/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000657841C | (05) | GA |
G01825 | (02) | GA |