MEDICARE: DR. THOMAS L GARVIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	79	GA

General Provider Information

NPI Number	:	1114910965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS L GARVIN MD

Provider Business Mailing Address
First Line	:	155 PINERIDGE WAY
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-3314
Country	:	US
Telephone Number	:	321-759-9548
Fax Number	:

Provider Business Practice Location Address
First Line	:	5551 EVERGLADES TRL
Second Line	:
City	:	NORCROSS
State	:	GA
Zip	:	30071-3070
Country	:	US
Telephone Number	:	470-505-7102
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	10/20/2025

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