Provider Demographics
NPI:1275979643
Name:OCCUPATIONAL HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSOM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-933-2008
Mailing Address - Street 1:4045 FIVE FORKS TRICKUM RD SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-2351
Mailing Address - Country:US
Mailing Address - Phone:404-933-2008
Mailing Address - Fax:404-933-2008
Practice Address - Street 1:4045 FIVE FORKS TRICKUM RD SW
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-2351
Practice Address - Country:US
Practice Address - Phone:404-933-2008
Practice Address - Fax:404-933-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-13
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
GA20120187012081P2900X, 251B00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
No174H00000XOther Service ProvidersHealth EducatorGroup - Single Specialty
No251B00000XAgenciesCase Management
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Single Specialty