Provider Demographics
NPI:1558599159
Name:EDWARDS, THOMAS E III (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:EDWARDS
Suffix:III
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 1:951 S BROAD ST
Mailing Address - Street 2:THOMASVILLE FAMILY MEDICINE CENTER
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6161
Mailing Address - Country:US
Mailing Address - Phone:229-228-4130
Mailing Address - Fax:229-226-4690
Practice Address - Street 1:951 S BROAD ST
Practice Address - Street 2:THOMASVILLE FAMILY MEDICINE CENTER
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6161
Practice Address - Country:US
Practice Address - Phone:229-228-4130
Practice Address - Fax:229-226-4690
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC31723207Q00000X
GA067559207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine