Provider Demographics
NPI:1700857695
Name:REES, THOMAS F (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:REES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SHORTER AVE SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-3964
Mailing Address - Country:US
Mailing Address - Phone:706-232-6464
Mailing Address - Fax:706-232-3674
Practice Address - Street 1:1501 SHORTER AVE SW
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30165-3964
Practice Address - Country:US
Practice Address - Phone:706-232-6464
Practice Address - Fax:706-232-3674
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA710-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA55422454SAMedicare ID - Type Unspecified
GAU22543Medicare UPIN