Mutton, Thomas Paul
Mutton, Thomas Paul is an individual health care provider with primary practice located at 1900 S Hawthorne Rd Suite 480, Winston Salem NC 27103-3913. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Mutton, Thomas Paul can be contacted via phone (336) 765-0155.Contact Information
Primary practice address
1900 S Hawthorne Rd Suite 480
Winston Salem NC 27103-3913
Phone: (336) 765-0155
Fax: (336) 765-5494
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 18688 | North Carolina |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 18688 | North Carolina |
Profile Details
| NPI number | 1760483689 |
|---|---|
| LBN Legal business name | Mutton, Thomas Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Oct 25th, 2020 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760483689 | NPPES |
| Other | 61648 | BLUE CROSS/BLUESHIELD | |
| Other | 122902 | BLUE CROSS/BLUESHIELD | |
| Other | 1319922 | BLUE CROSS/BLUESHIELD | |
| Other | 125882 | BLUE CROSS/BLUESHIELD | |
| Other | 546165 | BLUE CROSS/BLUESHIELD | |
| Other | 28536 | BLUE CROSS/BLUESHIELD | |
| MEDICAID | 8961648 | BLUE CROSS/BLUESHIELD | |
| Other | 2072030 | BLUE CROSS/BLUESHIELD |
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