Puckett, Thomas G
Puckett, Thomas G is an individual health care provider with primary practice located at 1107 S 34Th Ave , Hattiesburg MS 39402-3004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Puckett, Thomas G can be contacted via phone (601) 268-1988.Contact Information
Primary practice address
1107 S 34Th Ave
Hattiesburg MS 39402-3004
Phone: (601) 268-1988
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 06231 | Mississippi |
Profile Details
NPI number | 1841308160 |
---|---|
LBN Legal business name | Puckett, Thomas G |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 27th, 2006 |
Last updated | Aug 3rd, 2022 - about 2 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 | 1841308160 | NPPES |
Mississippi | MEDICAID | 00120180 | |
Mississippi | MEDICAID | 009924610 | |
Mississippi | Other | 1559101 | |
Mississippi | MEDICAID | 1561274 |
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