Thaggard, Michael Stacy

Thaggard, Michael Stacy is an individual health care provider with primary practice located at 1203 24Th Ave , Meridian MS 39301-3926. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Thaggard, Michael Stacy can be contacted via phone (601) 693-5862.

Contact Information

Primary practice address
1203 24Th Ave Meridian MS 39301-3926
Fax: (601) 693-9314
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 12892 Mississippi

Profile Details

NPI number 1659352011
LBN Legal business name Thaggard, Michael Stacy
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 10th, 2005
Last updated Jul 8th, 2007 - about 17 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 1659352011 NPPES
Mississippi MEDICAID 00113689

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