Provider Demographics
NPI:1295034551
Name:KUPRYS, TOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:TOMAS
Middle Name:
Last Name:KUPRYS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 VERNON RD
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:GA
Mailing Address - Zip Code:30240-3871
Mailing Address - Country:US
Mailing Address - Phone:706-845-9824
Mailing Address - Fax:
Practice Address - Street 1:771 OLD NORCROSS RD STE 105
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4977
Practice Address - Country:US
Practice Address - Phone:770-509-4030
Practice Address - Fax:404-847-4488
Is Sole Proprietor?:No
Enumeration Date:2011-03-24
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2453207R00000X
IL1111207X00000X
NY0000207XS0117X
GA79992207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery