Forks, Thomas P

Forks, Thomas P is an individual health care provider with primary practice located at 7275 S Siwell Rd , Jackson MS 39272-9776. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Forks, Thomas P can be contacted via phone (601) 373-7722.

Contact Information

Primary practice address
7275 S Siwell Rd Jackson MS 39272-9776
Phone: (601) 373-7722
Fax: (601) 373-7378
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12215 Mississippi

Profile Details

NPI number 1164499190
LBN Legal business name Forks, Thomas P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated Dec 2nd, 2010 - about 15 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 1164499190 NPPES
Mississippi Other 753068151 MS HEALTH PARTNERS
Mississippi Other 753068151 MS HEALTH PARTNERS
Mississippi MEDICAID 00119587 MS HEALTH PARTNERS
Mississippi Other 4253992 MS HEALTH PARTNERS
Mississippi Other P00138501 MS HEALTH PARTNERS
Mississippi Other 168390702 MS HEALTH PARTNERS
Mississippi Other 753068151008 MS HEALTH PARTNERS
Mississippi Other 753068151 MS HEALTH PARTNERS

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