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General NPI Number Information
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NPI Number | 1255312963
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Entity Type | Individual
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Provider Name | GEORGE SHERMAN THURMOND II OD
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Gender | Male
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Dates
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Enumeration Date | 11/09/2005
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 5500 W FRIENDLY AVE SUITE 200
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City | GREENSBORO
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State | NC
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Zip | 27410-4212
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Country | US
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Telephone | 336-292-4516
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Fax | 336-292-5706
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Provider Business Mailing Address
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Address Line | 5500 W FRIENDLY AVE SUITE 200
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City | GREENSBORO
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State | NC
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Zip | 27410-4212
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Country | US
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Telephone | 336-292-4516
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Fax | 336-292-5706
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1402
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License Number State | NC
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