Provider Demographics
NPI:1609848373
Name:KIAS, THOMAS N (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:N
Last Name:KIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1010 PRINCE AVE
Mailing Address - Street 2:STE 151
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-5896
Mailing Address - Country:US
Mailing Address - Phone:706-546-0832
Mailing Address - Fax:706-546-7036
Practice Address - Street 1:1010 PRINCE AVE
Practice Address - Street 2:STE 151
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-5896
Practice Address - Country:US
Practice Address - Phone:706-546-0832
Practice Address - Fax:706-546-7036
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-06
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA12503207R00000X
GA012503207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00084906AMedicaid
GAD29923Medicare UPIN
GA00084906AMedicaid