Provider Demographics
NPI:1710045653
Name:REHABILITACTICS, PC
Entity type:Organization
Organization Name:REHABILITACTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARRON
Authorized Official - Middle Name:L
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-522-2422
Mailing Address - Street 1:PO BOX 2889
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30031-2889
Mailing Address - Country:US
Mailing Address - Phone:404-522-2422
Mailing Address - Fax:404-522-2292
Practice Address - Street 1:501 PULLIAM ST SW
Practice Address - Street 2:SUITE 144
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2755
Practice Address - Country:US
Practice Address - Phone:404-522-2422
Practice Address - Fax:404-242-2292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039965208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1669462883OtherNPI FOR S. THOMPSON, MD
1669462883OtherNPI FOR S. THOMPSON, MD
25BBFVCMedicare ID - Type UnspecifiedGEORGIA MEDICARE NUMBER