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:
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Health care specialties

SpecialtyCodeLicense #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 3 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 1841308160 NPPES
Mississippi MEDICAID 00120180
Mississippi MEDICAID 009924610
Mississippi Other 1559101
Mississippi MEDICAID 1561274

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