Theis, Warren Stuart

Theis, Warren Stuart is an sole proprietor health care provider with primary practice located at 1405 Alice St , Waycross GA 31501-4528. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Theis, Warren Stuart can be contacted via phone (912) 285-8822.

Contact Information

Primary practice address
1405 Alice St Waycross GA 31501-4528
Phone: (912) 285-8822
Fax: (912) 285-8898
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 055345 Georgia
Allopathic & Osteopathic Physicians / General Practice 208D00000X 0101237160 Virginia
Allopathic & Osteopathic Physicians / General Practice 208D00000X A84102 California
Allopathic & Osteopathic Physicians / General Practice 208D00000X ME96329 Florida

Profile Details

NPI number 1588658702
LBN Legal business name Theis, Warren Stuart
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 2nd, 2005
Last updated Jun 3rd, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588658702 NPPES
Georgia MEDICAID 67269005A

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