Provider Demographics
NPI:1932166261
Name:THOMAS, JOHN MARION JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MARION
Last Name:THOMAS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5445 MERIDIAN MARKS RD NE
Mailing Address - Street 2:STE 380
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4763
Mailing Address - Country:US
Mailing Address - Phone:404-705-3100
Mailing Address - Fax:404-705-3040
Practice Address - Street 1:5445 MERIDIAN MARKS RD NE
Practice Address - Street 2:STE 380
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-4763
Practice Address - Country:US
Practice Address - Phone:404-705-3100
Practice Address - Fax:404-705-3040
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2013-11-21
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Provider Licenses
StateLicense IDTaxonomies
GA034258208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
G03950Medicare UPIN