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General NPI Number Information
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NPI Number | 1407939564
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Entity Type | Organization
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Legal Business Name | THOMASVILLE FAMILY MEDICINE CENTER, LLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/25/2015
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Provider Practice Location Address
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Address Line | 951 S BROAD ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-6161
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Country | US
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Telephone | 229-228-4130
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Fax | 229-226-4690
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Provider Business Mailing Address
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Address Line | 951 S BROAD ST
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City | THOMASVILLE
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State | GA
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Zip | 31792-6161
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Country | US
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Telephone | 229-228-4130
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Fax | 229-226-4690
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Authorized Official
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Title or Position | PARTNER
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Name | CALVIN J REAMS
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Credential | MD
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Telephone | 229-228-4130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 019585
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 002549
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 045799
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 046526
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 033433
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 067205
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 067559
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 029087
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License Number State | GA
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