Healthcare Provider Details

I. General information

NPI: 1922093665
Provider Name (Legal Business Name): THOMAS A HILSMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2005
Last Update Date: 06/09/2023
Certification Date: 06/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

771 ROUNDTREE DR SW STE A
DAWSON GA
39842-1683
US

IV. Provider business mailing address

771 ROUNDTREE DR SW STE A
DAWSON GA
39842-1683
US

V. Phone/Fax

Practice location:
  • Phone: 229-270-1905
  • Fax: 229-270-1915
Mailing address:
  • Phone: 229-270-1905
  • Fax: 229-270-1915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number015591
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: