MEDICARE: JASON THOMAS

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
1	163W00000X	Registered Nurse	RN302180	GA

General Provider Information

NPI Number	:	1710818422
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON THOMAS

Provider Business Mailing Address
First Line	:	4267 WINDING TRAIL LN
Second Line	:
City	:	DOUGLASVILLE
State	:	GA
Zip	:	30135-7226
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3896 PRINCETON LAKES WAY SW
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30331-5510
Country	:	US
Telephone Number	:	404-489-4444
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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Directions to “ JASON THOMAS ” Practice Location

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