Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 026011 | GA |
Y | 208200000X | Surgeon | 26011 | GA |
Y | 208600000X | Surgeon | 26011 | GA |
N | 2086S0120X | Pediatric Surgery | 026011 | GA |
NPI | 1619927605 |
---|---|
Provider Name | Thomas C Pearson |
First Address | Atlanta, GA 30322 |
Second Address | Atlanta, GA 30322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 05/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D46199 | (02) |