Provider Demographics
NPI:1992940217
Name:REEVE, THOMAS ELLIS IV (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ELLIS
Last Name:REEVE
Suffix:IV
Gender:
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:706 DIXIE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3858
Mailing Address - Country:US
Mailing Address - Phone:770-838-8710
Mailing Address - Fax:770-812-5735
Practice Address - Street 1:157 CLINIC AVE STE 302
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117
Practice Address - Country:US
Practice Address - Phone:770-812-5902
Practice Address - Fax:770-812-5903
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA793192086S0129X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery