Provider Demographics
NPI:1972526614
Name:THOMAS, GEORGE G (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:G
Last Name:THOMAS
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:PO BOX 70365
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36107-0365
Mailing Address - Country:US
Mailing Address - Phone:334-420-5038
Mailing Address - Fax:334-420-0158
Practice Address - Street 1:100 OAK STREET
Practice Address - Street 2:
Practice Address - City:HAYNEVILLE
Practice Address - State:AL
Practice Address - Zip Code:36040
Practice Address - Country:US
Practice Address - Phone:334-548-2516
Practice Address - Fax:334-548-2521
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00011533207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51516415OtherBCBS
AL630904078Medicaid
AL630908078Medicaid
AL15111572OtherBCBS
AL51516412OtherBCBS
AL51516423OtherBCBS
AL630907070Medicaid
AL630910070Medicaid
ALP00044366OtherRAILROAD
AL51516346OtherBCBS
AL51516416OtherBCBS
AL51524616OtherBCBS
AL630901070Medicaid
AL630909070Medicaid
AL15111572OtherBCBS
AL51524616OtherBCBS