Potts, Thomas R

Potts, Thomas R is an individual health care provider with primary practice located at 2100 Highway 61 N , Vicksburg MS 39183-8211. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Potts, Thomas R can be contacted via phone (601) 883-5000.

Contact Information

Primary practice address
2100 Highway 61 N Vicksburg MS 39183-8211
Phone: (601) 883-5000
Fax: (601) 883-5196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R865054 Mississippi

Profile Details

NPI number 1841417656
LBN Legal business name Potts, Thomas R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2007
Last updated Apr 8th, 2009 - 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 1841417656 NPPES
Other P00675194 RAIL ROAD MEDICARE
MEDICAID 00639559 RAIL ROAD MEDICARE
MEDICAID 1358886 RAIL ROAD MEDICARE

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