Provider Demographics
NPI:1538161070
Name:BAIR, THOMAS LOUIS II (LAT, ATC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:LOUIS
Last Name:BAIR
Suffix:II
Gender:M
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:GRIFFIN
Mailing Address - State:GA
Mailing Address - Zip Code:30224-4238
Mailing Address - Country:US
Mailing Address - Phone:770-233-1800
Mailing Address - Fax:770-233-0005
Practice Address - Street 1:124 W COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GRIFFIN
Practice Address - State:GA
Practice Address - Zip Code:30224-4238
Practice Address - Country:US
Practice Address - Phone:770-233-1800
Practice Address - Fax:770-233-0005
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0001002255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAAT000100OtherATHLETIC TRAINING LICENSE