Healthcare Provider Details

I. General information

NPI: 1972647436
Provider Name (Legal Business Name): GAIL THOMAS DMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2007
Last Update Date: 06/12/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

556 ELBERT ST
ELBERTON GA
30635-2347
US

IV. Provider business mailing address

556 ELBERT ST
ELBERTON GA
30635-2347
US

V. Phone/Fax

Practice location:
  • Phone: 706-283-3161
  • Fax: 706-283-3728
Mailing address:
  • Phone: 706-283-3161
  • Fax: 706-283-3728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN010712
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH011240
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: