NPI 1154735405

Micheal Thomas, DIRECTOR

Practitioner Private Vehicle Indianola, MS

Practice location

Address: 216 North Ave, Indianola, MS 38751-2131
Phone: (662) 336-8087

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X Licence 800064763 (MS)

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Registry record

NPI: 1154735405
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jun 2014
Record last updated: 15 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.