Provider Demographics
NPI:1730195348
Name:THAI, THANG (PA-A)
Entity type:Individual
Prefix:MR
First Name:THANG
Middle Name:
Last Name:THAI
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Gender:M
Credentials:PA-A
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Mailing Address - Street 1:531 ROSELANE STREET NW
Mailing Address - Street 2:SUITE 750
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-6975
Mailing Address - Country:US
Mailing Address - Phone:770-794-0477
Mailing Address - Fax:770-794-3108
Practice Address - Street 1:531 ROSELANE STREET NW
Practice Address - Street 2:SUITE 750
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-6975
Practice Address - Country:US
Practice Address - Phone:770-794-0477
Practice Address - Fax:770-794-3108
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2014-08-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA007171367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant