| Paresh K Thanki, Md, Llc | |
|
1707 Boulevard Sq Ste A Waycross GA 31501-8030 | |
| (912) 490-0078 | |
| (912) 490-0083 |
| Full Name | Paresh K Thanki, Md, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1707 Boulevard Sq Ste A, Waycross, Georgia |
| Authorized Official Name and Position | Paresh K Thanki (PRESIDENT) |
| Authorized Official Contact | 9124900078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Paresh K Thanki, Md, Llc 3718 Vinebrooke Dr Valdosta GA 31605-7418 Ph: (912) 490-0078 | Paresh K Thanki, Md, Llc 1707 Boulevard Sq Ste A Waycross GA 31501-8030 Ph: (912) 490-0078 |
| NPI Number | 1093018806 |
|---|---|
| Provider Enumeration Date | 12/16/2010 |
| Last Update Date | 12/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093018806 | NPI | - | NPPES |
| 202I265217 | Other | GA | MEDICARE PTAN |
| 136071824E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | BT9306514 (Georgia) | Primary |
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