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NPI Code Detail

MEDICARE: DR. SUZANNE DIXSON THOMAS APRN-BC

MEDICARE: DR. SUZANNE DIXSON THOMAS APRN-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN101218 NPGA

General Provider Information

NPI Number : 1003862905
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SUZANNE DIXSON THOMAS APRN-BC
Provider Business Mailing Address
First Line : 300 GARDNERS MILL CT
Second Line :
City : AUGUSTA
State : GA
Zip : 30907-3716
Country : US
Telephone Number : 706-651-0250
Fax Number :
Provider Business Practice Location Address
First Line : 1916 N LEG RD
Second Line : FAMILY HEALTH COORDINATOR, EAST CENTRAL HEALTH DISTRICT
City : AUGUSTA
State : GA
Zip : 30909-4402
Country : US
Telephone Number : 706-667-4285
Fax Number : 706-667-4607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 07/08/2007

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