Stallworth, Gregory Thomas

Stallworth, Gregory Thomas is an sole proprietor health care provider with primary practice located at 1430 Hwy 4-East , Holly Springs MS 38634. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Stallworth, Gregory Thomas can be contacted via phone (662) 551-3369.

Contact Information

Primary practice address
1430 Hwy 4-East Holly Springs MS 38634
Phone: (662) 551-3369
Fax: (662) 551-3421
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 00578 Mississippi

Profile Details

NPI number 1043314057
LBN Legal business name Stallworth, Gregory Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 11th, 2006
Last updated Jul 8th, 2007 - about 18 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 1043314057 NPPES
Mississippi MEDICAID 00116623

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