Wiley-Lucas, Thelma E

Wiley-Lucas, Thelma E is an individual health care provider with primary practice located at 157 Clinic Ave Ste 201 , Carrollton GA 30117-4454. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Wiley-Lucas, Thelma E can be contacted via phone (770) 214-2800.

Contact Information

Primary practice address
157 Clinic Ave Ste 201 Carrollton GA 30117-4454
Phone: (770) 214-2800
Fax: (770) 214-2803
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 058487 Georgia

Profile Details

NPI number 1366478653
LBN Legal business name Wiley-Lucas, Thelma E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2006
Last updated Jan 31st, 2024 - about 10 months 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 1366478653 NPPES
Georgia MEDICAID 179173719A
Georgia Other P00384988

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