Provider Demographics
NPI:1245233584
Name:LOVAS, THOMAS R (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:R
Last Name:LOVAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 W HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:FORT GORDON
Mailing Address - State:GA
Mailing Address - Zip Code:30905-5741
Mailing Address - Country:US
Mailing Address - Phone:706-787-7155
Mailing Address - Fax:
Practice Address - Street 1:905 STEVENS CREEK RD
Practice Address - Street 2:STE 14
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30907-3201
Practice Address - Country:US
Practice Address - Phone:706-922-6000
Practice Address - Fax:706-722-7994
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2022-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7780207W00000X
GAGA 049646207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK201090400AMedicaid
GA00901843BMedicaid
SCGPA 573Medicaid
GA18BDGCGMedicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMB