Thorne, Keith Derek

Thorne, Keith Derek is an individual health care provider with primary practice located at 501 Marshall St Ste 104 , Jackson MS 39202-1663. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Thorne, Keith Derek can be contacted via phone (601) 969-6404.

Contact Information

Primary practice address
501 Marshall St Ste 104 Jackson MS 39202-1663
Phone: (601) 969-6404
Fax: (601) 973-4541
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 17941 Mississippi

Profile Details

NPI number 1467559476
LBN Legal business name Thorne, Keith Derek
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Apr 4th, 2018 - about 8 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 1467559476 NPPES
Mississippi MEDICAID 09775722

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