Fowlkes, Thomas D

Fowlkes, Thomas D is an individual health care provider with primary practice located at 1916 University Ave , Oxford MS 38655-4114. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Fowlkes, Thomas D can be contacted via phone (662) 281-1306.

Contact Information

Primary practice address
1916 University Ave Oxford MS 38655-4114
Phone: (662) 281-1306
Fax: (662) 281-1326
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 13406 Mississippi
Allopathic & Osteopathic Physicians / General Practice 208D00000X 13406 Mississippi
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 13406 Mississippi

Profile Details

NPI number 1477649218
LBN Legal business name Fowlkes, Thomas D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Jul 10th, 2012 - about 13 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 1477649218 NPPES
Mississippi MEDICAID 01508551
Mississippi Other 5916714

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