=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255272415
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS POLLARD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/02/2026
-----------------------------------------------------
Last Update Date | 04/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2190 GILMER AVE
-----------------------------------------------------
City | TALLASSEE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36078-7123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 334-991-3207
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4477 LEE ROAD 137 LOT 21
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36832-8032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 390200000X
-----------------------------------------------------
Taxonomy Name | Student in an Organized Health Care Education/Training Program
-----------------------------------------------------
License Number | S14621
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------