Provider Demographics
NPI:1265502926
Name:THOMAS H. PIERZCHALA, M.D., P.C.
Entity Type:Organization
Organization Name:THOMAS H. PIERZCHALA, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:PIERZCHALA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:706-290-9999
Mailing Address - Street 1:304A E 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30161-3222
Mailing Address - Country:US
Mailing Address - Phone:706-290-2222
Mailing Address - Fax:706-290-1999
Practice Address - Street 1:304A E 2ND AVE
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3222
Practice Address - Country:US
Practice Address - Phone:706-290-2222
Practice Address - Fax:706-290-1999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033431207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAB34617Medicare UPIN
GAGRP5086Medicare ID - Type Unspecified