Sistrunk, Thomas Lewis
Sistrunk, Thomas Lewis is an individual health care provider with primary practice located at 705 Dixie St , Carrollton GA 30117-3818. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Sistrunk, Thomas Lewis can be contacted via phone (770) 836-9660.Contact Information
Primary practice address
705 Dixie St
Carrollton GA 30117-3818
Phone: (770) 836-9660
Fax: (770) 812-5028
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 019424 | Georgia |
Profile Details
| NPI number | 1063486843 |
|---|---|
| LBN Legal business name | Sistrunk, Thomas Lewis |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 2006 |
| Last updated | Jan 28th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063486843 | NPPES |
| Georgia | MEDICAID | 000229567B | |
| Georgia | Other | 028143 |
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