Provider Demographics
NPI:1659484327
Name:HURD, THOMAS E (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:HURD
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 1:400 TOWER RD NE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30061-9415
Mailing Address - Country:US
Mailing Address - Phone:770-590-1078
Mailing Address - Fax:770-422-7306
Practice Address - Street 1:400 TOWER ROAD
Practice Address - Street 2:SUITE 350
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-9415
Practice Address - Country:US
Practice Address - Phone:770-590-1078
Practice Address - Fax:770-422-7306
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA027070208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA737771OtherFIRST HEALTH
GA000297041GMedicaid
GA582317219OtherHUMANA
GA24380OtherCOVENTRY HEALTHCARE
GA4211380OtherAETNA US HEALTHCARE
GA7233100OtherCIGNA HEALTHCARE
GA7233100OtherCIGNA HEALTHCARE
GA05BDGBVMedicare PIN