Provider Demographics
NPI:1174603112
Name:GUFFIN, THOMAS N JR (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:N
Last Name:GUFFIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PEACHTREE STREET, NW
Mailing Address - Street 2:SUITE 700
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2511
Mailing Address - Country:US
Mailing Address - Phone:404-350-7966
Mailing Address - Fax:404-350-7968
Practice Address - Street 1:1800 PEACHTREE STREET, NW
Practice Address - Street 2:SUITE 700
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2511
Practice Address - Country:US
Practice Address - Phone:404-350-7966
Practice Address - Fax:404-350-7968
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA032199174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA04BDCNDMedicare ID - Type Unspecified