MEDICARE: PARESH THANKI M.D.

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	2084P0800X	Psychiatry Physician	55344	GA

General Provider Information

NPI Number	:	1982786224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PARESH THANKI M.D.

Provider Business Mailing Address
First Line	:	3718 VINEBROOKE DRIVE
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602
Country	:	US
Telephone Number	:	229-244-9686
Fax Number	:

Provider Business Practice Location Address
First Line	:	3120 N OAK STREET EXT STE B
Second Line	:
City	:	VALDOSTA
State	:	GA
Zip	:	31602-5910
Country	:	US
Telephone Number	:	229-671-6100
Fax Number	:

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	09/16/2013

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