Blanks, Thomas

Blanks, Thomas is an individual health care provider with primary practice located at 1110 Broad Ave Suite 700, Gulfport MS 39501-8907. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Blanks, Thomas can be contacted via phone (228) 864-0314.

Contact Information

Primary practice address
1110 Broad Ave Suite 700 Gulfport MS 39501-8907
Phone: (228) 864-0314
Fax: (228) 864-0425
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 08702 Mississippi

Profile Details

NPI number 1063452639
LBN Legal business name Blanks, Thomas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Jul 10th, 2014 - about 12 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 1063452639 NPPES
Mississippi MEDICAID 00112507
Mississippi Other P00651241

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