Basic Information
| Provider Information | |||||||||
| NPI: | 1275535593 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARIGAN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | PHILIP | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | BLDG 300 EAST HOSPITAL ROAD | ||||||||
| Address2: | DDEAMC (ATTN: DFCM-FMC) | ||||||||
| City: | FORT GORDON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309053851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067879355 | ||||||||
| FaxNumber: | 7067879356 | ||||||||
| Practice Location | |||||||||
| Address1: | BLDG 300 EAST HOSPITAL ROAD | ||||||||
| Address2: | DDEAMC (ATTN: DFCM-FMC) | ||||||||
| City: | FORT GORDON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309053851 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067879355 | ||||||||
| FaxNumber: | 7067879356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2005 | ||||||||
| LastUpdateDate: | 05/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 05/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 034140 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2021087689 | 01 | GA | MEDICARE PROVIDER TRANSACTION ACCESS NUMBER | OTHER |