Gore, Thomas B

Gore, Thomas B is an individual health care provider with primary practice located at 1551 Doctors Dr Building 200, Lagrange GA 30240-4139. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Gore, Thomas B can be contacted via phone (706) 884-2641.

Contact Information

Primary practice address
1551 Doctors Dr Building 200 Lagrange GA 30240-4139
Fax: (706) 884-2353
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 027553 Georgia

Profile Details

NPI number 1639164874
LBN Legal business name Gore, Thomas B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Sep 30th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639164874 NPPES
Georgia MEDICAID 000304961A

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