Provider Demographics
NPI:1730245200
Name:FORD, THOMAS AARON (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:AARON
Last Name:FORD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LA FAYETTE
Mailing Address - State:GA
Mailing Address - Zip Code:30728-2137
Mailing Address - Country:US
Mailing Address - Phone:706-639-3333
Mailing Address - Fax:706-638-6665
Practice Address - Street 1:1304 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LA FAYETTE
Practice Address - State:GA
Practice Address - Zip Code:30728-2137
Practice Address - Country:US
Practice Address - Phone:706-639-3333
Practice Address - Fax:706-638-6665
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR006085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFHRMedicare ID - Type Unspecified