Provider Demographics
NPI:1710193099
Name:NOWLIN, THOMAS J (RPH)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:NOWLIN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 MIDLAND TRCE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31820-3426
Mailing Address - Country:US
Mailing Address - Phone:706-568-4447
Mailing Address - Fax:706-571-1787
Practice Address - Street 1:5120 MIDLAND TRCE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:GA
Practice Address - Zip Code:31820-3426
Practice Address - Country:US
Practice Address - Phone:706-568-4447
Practice Address - Fax:706-571-1787
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14538183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy