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Contact Information

THOMAS W MCCORMACK JR, MD
1361 JENNINGS MILL ROAD
BUILDING 200 SUITE 201
BOGART, GA30622
 Phone: 706-316-1908
 Fax: 706-316-2062
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for THOMAS W MCCORMACK JR · (Male)

NPI Number 1740298728
Status Active
Credentials MD
Entity Individual
Enumeration date 08/04/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • GA License # GA051255
  • GA Medicaid 00958625A
Hospital affiliation(s)
  • ATHENS REGIONAL MEDICAL CENTER - (Acute Care)
    1199 PRINCE AVENUE
    ATHENS, GA 30606
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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