Provider Demographics
NPI:1932321833
Name:THOMAS, SHARON HOLDEN (OD)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:HOLDEN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11460 JOHNS CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-1518
Mailing Address - Country:US
Mailing Address - Phone:678-415-3839
Mailing Address - Fax:
Practice Address - Street 1:11460 JOHNS CREEK PKWY
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-1518
Practice Address - Country:US
Practice Address - Phone:678-415-3839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT001013152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management