Thomas P Forks, DO | |
7275 S Siwell Rd, Jackson, MS 39272-9776 | |
(601) 373-7722 | |
(601) 373-7378 |
Full Name | Thomas P Forks |
---|---|
Gender | Male |
Speciality | Family Medicine |
Location | 7275 S Siwell Rd, Jackson, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164499190 | NPI | - | NPPES |
753068151 | Other | MS | MS HEALTH PARTNERS |
753068151 | Other | MS | 1ST CHOICE |
00119587 | Medicaid | MS | |
4253992 | Other | MS | AETNA |
P00138501 | Other | MS | RAILROAD MEDICARE |
168390702 | Other | MS | DEPARTMENT OF LABOR |
753068151008 | Other | MS | TRICARE |
753068151 | Other | MS | MS PHYSICIANS CARE NETWOR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 12215 (Mississippi) | Primary |
Entity Name | First Intermed Corporation |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669406658 PECOS PAC ID: 5294629895 Enrollment ID: O20040213000105 |
Mailing Address | Practice Location Address |
---|---|
Thomas P Forks, DO 1151 N State St, Suite 408, Jackson, MS 39202-2407 Ph: (601) 292-4261 | Thomas P Forks, DO 7275 S Siwell Rd, Jackson, MS 39272-9776 Ph: (601) 373-7722 |
Dr. Tesia Shani Hall-hill, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5429 Robinson Road Ext, Jackson, MS 39204 Phone: 601-914-0163 Fax: 601-914-0170 | |
Mrs. Christian Fortenberry, FNP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 971 Lakeland Dr Ste 557, Jackson, MS 39216 Phone: 601-200-4560 | |
Dr. Marcia L Howard, Family Medicine Medicare: Medicare Enrolled Practice Location: 2500 N State St, Dept Of Family Medicine, Jackson, MS 39216 Phone: 601-984-5426 Fax: 601-984-6889 | |
Stephen Paul Epperson, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1225 N State St, Jackson, MS 39202 Phone: 601-988-5281 Fax: 601-974-5241 | |
Deborah O'bryan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 2500 N State St, Jackson, MS 39216 Phone: 601-815-4778 Fax: 601-984-5420 | |
Dr. Cassandra Faye Thomas, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 514c E Woodrow Wilson Ave, Jackson, MS 39216 Phone: 601-981-7198 Fax: 601-981-6616 | |
Mrs. Sydney Mccary Ponder, Family Medicine Medicare: Medicare Enrolled Practice Location: 1325 E Fortification St, Jackson, MS 39202 Phone: 601-354-4488 |