Provider Demographics
NPI:1982990966
Name:SHOLES, THOMAS TAYLOR (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:TAYLOR
Last Name:SHOLES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1000 HAWTHORNE AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-2168
Mailing Address - Country:US
Mailing Address - Phone:706-286-8692
Mailing Address - Fax:706-286-8693
Practice Address - Street 1:1000 HAWTHORNE AVE
Practice Address - Street 2:SUITE K
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-2168
Practice Address - Country:US
Practice Address - Phone:706-286-8692
Practice Address - Fax:706-286-8693
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA4752207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology