Provider Demographics
NPI:1922003904
Name:PARROTT, THOMAS B (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:B
Last Name:PARROTT
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 1:1192 ROCKBRIDGE RD STE A
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-2923
Mailing Address - Country:US
Mailing Address - Phone:770-925-2010
Mailing Address - Fax:770-925-1665
Practice Address - Street 1:1192 ROCKBRIDGE RD STE A
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30087-2923
Practice Address - Country:US
Practice Address - Phone:770-925-2010
Practice Address - Fax:770-925-1665
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA63514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT4991Medicaid
VT8000080Medicaid
VTB86232Medicare UPIN
GAGRP7857Medicare PIN