Provider Demographics
NPI:1134253552
Name:THOMAS, JOYCE (MD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 SUNSET DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2293
Mailing Address - Country:US
Mailing Address - Phone:706-543-3400
Mailing Address - Fax:706-543-6191
Practice Address - Street 1:700 SUNSET DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2293
Practice Address - Country:US
Practice Address - Phone:706-543-3400
Practice Address - Fax:706-543-6191
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2011-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA021353207N00000X, 207NS0135X, 207ZD0900X, 207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology
No207ZD0900XAllopathic & Osteopathic PhysiciansPathologyDermatopathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00336135AMedicaid
GA00336135AMedicaid