Search › Georgia › 207Q00000X
Tyler Provost, D.O
NPI 1588186191 · on the registry since 2017
Practice
- Address
- 2508 University Dr
Thomson, GA 30824 - Phone
- (706) 595-1090
- Fax
- (706) 595-6010
- Organisation at this address
- Family Care Group Of Thomson,Inc
Neighborhood Improvement Project IncInferred from a shared address, not stated in the registry. - Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-11-24
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia