Gaillard, Thaddeus B

Gaillard, Thaddeus B is an individual health care provider with primary practice located at 401 Southcrest Circle Suite 102, Southaven MS 38671. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Gaillard, Thaddeus B can be contacted via phone (662) 349-4377.

Contact Information

Primary practice address
401 Southcrest Circle Suite 102 Southaven MS 38671
Phone: (662) 349-4377
Fax: (662) 349-4378
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 15990 Tennessee
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 11279 Mississippi

Profile Details

NPI number 1558413807
LBN Legal business name Gaillard, Thaddeus B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Feb 15th, 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 1558413807 NPPES
Tennessee MEDICAID 3018336

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