Provider Demographics
NPI:1811979339
Name:HAYWOOD, TOMMIE III (MD)
Entity type:Individual
Prefix:DR
First Name:TOMMIE
Middle Name:
Last Name:HAYWOOD
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2208
Mailing Address - Country:US
Mailing Address - Phone:404-888-7575
Mailing Address - Fax:404-885-7777
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 350
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6149
Practice Address - Country:US
Practice Address - Phone:678-553-0226
Practice Address - Fax:678-553-0029
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2014-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA49420207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA640122796DMedicaid
GA640122796DMedicaid
GAH80326Medicare UPIN