Putnam, Samuel G

Putnam, Samuel G is an individual health care provider with primary practice located at 55 Physicians Ln , Southaven MS 38671-9569. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Putnam, Samuel G can be contacted via phone (662) 655-2136.

Contact Information

Primary practice address
55 Physicians Ln Southaven MS 38671-9569
Phone: (662) 655-2136
Fax: (662) 996-2214
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X MD041221E Pennsylvania
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X C1-0011573 Delaware
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD041221E Pennsylvania
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X C1-0011573 Delaware
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 63241 Tennessee
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 28916 Mississippi

Profile Details

NPI number 1023066404
LBN Legal business name Putnam, Samuel G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated Oct 17th, 2021 - about 5 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 1023066404 NPPES
Pennsylvania Other 8215722 CIGNA HMO/PPO
Pennsylvania Other 1172545 CIGNA HMO/PPO
Pennsylvania Other 0546464000 CIGNA HMO/PPO
Pennsylvania Other 710371 CIGNA HMO/PPO
Pennsylvania MEDICAID 0012723560016 CIGNA HMO/PPO
Pennsylvania Other 0546464000 CIGNA HMO/PPO
Pennsylvania Other 30026885 CIGNA HMO/PPO
Pennsylvania Other 300099781 CIGNA HMO/PPO
Pennsylvania Other 7929044 CIGNA HMO/PPO

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