Sog Physical Therapy | |
1211 S Gloster St Ste C Tupelo MS 38801-6535 | |
(662) 767-4200 | |
(767) 420-4662 |
Full Name | Sog Physical Therapy |
---|---|
Speciality | Clinic/Center |
Location | 1211 S Gloster St Ste C, Tupelo, Mississippi |
Authorized Official Name and Position | Thomas Luster (CEO) |
Authorized Official Contact | 6627674200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Sog Physical Therapy 1211 S Gloster St Tupelo MS 38801-6546 Ph: (662) 432-1523 | Sog Physical Therapy 1211 S Gloster St Ste C Tupelo MS 38801-6535 Ph: (662) 767-4200 |
NPI Number | 1902361660 |
---|---|
Provider Enumeration Date | 02/07/2019 |
Last Update Date | 09/03/2024 |
Medicare PECOS PAC ID | 1850627209 |
---|---|
Medicare Enrollment ID | O20190724000229 |
Identifier | Type | State | Issuer |
---|---|---|---|
1902361660 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Gabrielle Chiniche |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1003842758 PECOS PAC ID: 9830108455 Enrollment ID: I20060824000450 |
Provider Name | Kaye Cannon |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1972561470 PECOS PAC ID: 5294893129 Enrollment ID: I20081022000316 |
Provider Name | Paul A Kosko |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1871722173 PECOS PAC ID: 3375697766 Enrollment ID: I20090819000788 |
Provider Name | Emily Mccafferty |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1215244066 PECOS PAC ID: 2769664978 Enrollment ID: I20110309000657 |
Provider Name | Cody L Pounders |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1881076362 PECOS PAC ID: 8325355308 Enrollment ID: I20170504001979 |
Provider Name | Jamee F Zepponi |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1023548310 PECOS PAC ID: 9436429545 Enrollment ID: I20170724000832 |
Provider Name | Courtney Martin Purvis |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1447774682 PECOS PAC ID: 8123391075 Enrollment ID: I20170829001739 |
Provider Name | Laken Hood Richardson |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1609386515 PECOS PAC ID: 2860758455 Enrollment ID: I20171115000945 |
Provider Name | Cortni Cooper |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1881187417 PECOS PAC ID: 0143575886 Enrollment ID: I20180620001497 |
Provider Name | Dawn Turman Bean |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1992139570 PECOS PAC ID: 9335490952 Enrollment ID: I20180920002903 |
Provider Name | Ryan Mathis Shotts |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1588131106 PECOS PAC ID: 8729322714 Enrollment ID: I20181203000200 |
Provider Name | Catherine Claire Hays |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1902465347 PECOS PAC ID: 9133456643 Enrollment ID: I20190806004257 |
Provider Name | Carolyn Hill Walker |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1659788347 PECOS PAC ID: 8426371899 Enrollment ID: I20190807003473 |
Provider Name | Taylor M Johnson |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1700431004 PECOS PAC ID: 5496083727 Enrollment ID: I20190826000704 |
Provider Name | Kelly Sterling-gregory |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1730594383 PECOS PAC ID: 6901134238 Enrollment ID: I20190826000899 |
Provider Name | Dallis Glenn Forsythe |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1760040984 PECOS PAC ID: 6800127960 Enrollment ID: I20191004000482 |
Provider Name | Virginia M Sprayberry |
---|---|
Provider Type | Practitioner - Qualified Speech Language Pathologist |
Provider Identifiers | NPI Number: 1194203505 PECOS PAC ID: 9335572767 Enrollment ID: I20191125003052 |
Provider Name | Hana G Cooper |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1568004950 PECOS PAC ID: 0941633317 Enrollment ID: I20191126001559 |
Provider Name | Christy L Flynn |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1932543055 PECOS PAC ID: 1456779560 Enrollment ID: I20200921003194 |
Provider Name | Collin Sanders |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1720693245 PECOS PAC ID: 8527488659 Enrollment ID: I20201012001497 |
Provider Name | Katelyn M Alford |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1881294981 PECOS PAC ID: 5395155451 Enrollment ID: I20201102001486 |
Provider Name | James Ryan Wall |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1962071050 PECOS PAC ID: 9335540988 Enrollment ID: I20210702000945 |
Provider Name | Caley O'callaghan Speck |
---|---|
Provider Type | Practitioner - Occupational Therapist In Private Practice |
Provider Identifiers | NPI Number: 1003341462 PECOS PAC ID: 6608265194 Enrollment ID: I20211123001609 |
Provider Name | Christine Tran Bell |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1598245565 PECOS PAC ID: 0244622884 Enrollment ID: I20220112000200 |
Provider Name | Tyler Andrew King |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1831850957 PECOS PAC ID: 9537551106 Enrollment ID: I20220112001430 |
Provider Name | Lance Moore |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1992466411 PECOS PAC ID: 7517350671 Enrollment ID: I20220214000404 |
Provider Name | Joseph Cason Collins |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1184353237 PECOS PAC ID: 0648659953 Enrollment ID: I20220616001413 |
Provider Name | Rachel Marie Windham |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1376272278 PECOS PAC ID: 4284013947 Enrollment ID: I20220627001532 |
Provider Name | Meagan Paczesny |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1447413315 PECOS PAC ID: 0941374433 Enrollment ID: I20240213002472 |
South Madison Medical Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040a S. Madison St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
Nmmc Ekg Interpretations Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 830 S Gloster St, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2755 | |
North Mississippi Neurosurgical Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4381 S Eason Blvd, Suite 302, Tupelo, MS 38801 Phone: 662-377-5700 Fax: 662-377-5720 | |
Pontotoc Health Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 450 E President Ave, Tupelo, MS 38801 Phone: 662-377-4685 Fax: 662-377-2057 | |
Grant Family Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Varsity Dr, Tupelo, MS 38801 Phone: 484-252-6707 | |
North Mississippi Medical Clinics Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 450 E President Ave, Tupelo, MS 38801 Phone: 662-377-4685 | |
Advanced Wound Center Professionals Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 830 S Gloster St, 1st Floor East Tower, Tupelo, MS 38801 Phone: 662-377-2395 Fax: 662-377-2397 |