Poothullil, Thomas M

Poothullil, Thomas M is an sole proprietor health care provider with primary practice located at 2330 E Pass Rd Suite 3, Gulfport MS 39507-3817. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Poothullil, Thomas M can be contacted via phone (228) 896-7336.

Contact Information

Primary practice address
2330 E Pass Rd Suite 3 Gulfport MS 39507-3817
Fax: (228) 896-7996
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 07935 Mississippi

Profile Details

NPI number 1730220815
LBN Legal business name Poothullil, Thomas M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2007
Last updated Mar 3rd, 2010 - about 14 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 1730220815 NPPES
Mississippi MEDICAID 00016357

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