| Brian Thomas Psy D Pllc | |
|
144 S Thomas St Ste 104a Tupelo MS 38801-5337 | |
| (662) 231-8916 | |
| (662) 620-7106 |
| Full Name | Brian Thomas Psy D Pllc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 144 S Thomas St Ste 104a, Tupelo, Mississippi |
| Authorized Official Name and Position | Brian Thomas (OWNER) |
| Authorized Official Contact | 6626207102 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brian Thomas Psy D Pllc 144 S Thomas St Ste 103 Room 1 Tupelo MS 38801-5312 Ph: (662) 231-8916 | Brian Thomas Psy D Pllc 144 S Thomas St Ste 104a Tupelo MS 38801-5337 Ph: (662) 231-8916 |
| NPI Number | 1972924033 |
|---|---|
| Provider Enumeration Date | 12/16/2013 |
| Last Update Date | 03/22/2022 |
| Certification Date | 03/22/2022 |
| Medicare PECOS PAC ID | 5496976102 |
|---|---|
| Medicare Enrollment ID | O20141022001042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972924033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 40015 (Mississippi) | Primary |
| Provider Name | William B Thomas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720022973 PECOS PAC ID: 2365436060 Enrollment ID: I20040414000896 |
| Provider Name | Mary C Goysich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508804626 PECOS PAC ID: 4284622846 Enrollment ID: I20040503001225 |
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