Cosgrove, Thomas Bradley

Cosgrove, Thomas Bradley is an individual health care provider with primary practice located at 1850 Chadwick Dr , Jackson MS 39204-3404. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Cosgrove, Thomas Bradley can be contacted via phone (601) 376-1848.

Contact Information

Primary practice address
1850 Chadwick Dr Jackson MS 39204-3404
Phone: (601) 376-1848
Fax: (601) 376-1894
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R861282 Mississippi

Profile Details

NPI number 1407803422
LBN Legal business name Cosgrove, Thomas Bradley
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2006
Last updated Jul 8th, 2007 - 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 1407803422 NPPES
Mississippi MEDICAID 03189882

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