Puckette, Thomas Childs
Puckette, Thomas Childs is an individual health care provider with primary practice located at 1241 Woodland Avenue , Mount Pleasant SC 29464. He recently has 6 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Body Imaging, Allopathic & Osteopathic Physicians / Nuclear Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology, Allopathic & Osteopathic Physicians / Diagnostic Ultrasound. Allopathic & Osteopathic Physicians / Body Imaging is his primary health care specialty. Puckette, Thomas Childs can be contacted via phone (843) 824-0606.Contact Information
Primary practice address
1241 Woodland Avenue
Mount Pleasant SC 29464
Phone: (843) 824-0606
Fax: (843) 824-0909
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | ME17812 | South Carolina |
| Allopathic & Osteopathic Physicians / Nuclear Radiology | 2085N0904X | ME17812 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatric Radiology | 2085P0229X | ME17812 | South Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME17812 | South Carolina |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | ME17812 | South Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Ultrasound | 2085U0001X | ME17812 | South Carolina |
Profile Details
| NPI number | 1356350144 |
|---|---|
| LBN Legal business name | Puckette, Thomas Childs |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 8th, 2006 |
| Last updated | Jun 26th, 2008 - about 16 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 | 1356350144 | NPPES |
| South Carolina | Other | 1709 | MEDICARE GROUP |
| South Carolina | Other | 300125235 | MEDICARE GROUP |
| South Carolina | Other | 8683 | MEDICARE GROUP |
| South Carolina | MEDICAID | T17906 | MEDICARE GROUP |
| South Carolina | Other | 1138590 | MEDICARE GROUP |
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