Healthcare Provider Details

I. General information

NPI: 1245233584
Provider Name (Legal Business Name): THOMAS R. LOVAS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/31/2024
Certification Date: 07/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH STREET
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

300 W HOSPITAL RD
FORT GORDON GA
30905-5741
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-5222
  • Fax:
Mailing address:
  • Phone: 706-787-7155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number7780
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberGA 049646
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: