Beasley, Thomas Bass

Beasley, Thomas Bass is an individual health care provider with primary practice located at 5480 Goodman Rd Suite 2, Olive Branch MS 38654-7902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Beasley, Thomas Bass can be contacted via phone (662) 893-9815.

Contact Information

Primary practice address
5480 Goodman Rd Suite 2 Olive Branch MS 38654-7902
Phone: (662) 893-9815
Fax: (662) 893-9888
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 23320 Mississippi
Allopathic & Osteopathic Physicians / Surgery 208600000X 52023 Tennessee

Profile Details

NPI number 1538393905
LBN Legal business name Beasley, Thomas Bass
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 13th, 2009
Last updated Jun 11th, 2015 - about 11 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 1538393905 NPPES
Mississippi MEDICAID 00276815
Mississippi Other P01440718
Mississippi MEDICAID Q008144
Mississippi Other 6020201

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