Provider Demographics
NPI:1922093665
Name:HILSMAN, THOMAS A (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:HILSMAN
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 1:771 ROUNDTREE DR SW STE A
Mailing Address - Street 2:
Mailing Address - City:DAWSON
Mailing Address - State:GA
Mailing Address - Zip Code:39842-1683
Mailing Address - Country:US
Mailing Address - Phone:229-270-1905
Mailing Address - Fax:229-270-1915
Practice Address - Street 1:771 ROUNDTREE DR SW STE A
Practice Address - Street 2:
Practice Address - City:DAWSON
Practice Address - State:GA
Practice Address - Zip Code:39842-1683
Practice Address - Country:US
Practice Address - Phone:229-270-1905
Practice Address - Fax:229-270-1915
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA015591207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA080138371OtherRR MEDICARE PROVIDER #
GA0002227675CMedicaid
GA080138371OtherRR MEDICARE PROVIDER #
GAB92312Medicare UPIN