Provider Demographics
NPI:1235568916
Name:BILLUPS, THOMAS KEENER SR (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:KEENER
Last Name:BILLUPS
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 ALLYSON DR
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-1045
Mailing Address - Country:US
Mailing Address - Phone:662-231-2510
Mailing Address - Fax:662-844-3333
Practice Address - Street 1:1929 ALLYSON DR
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-1045
Practice Address - Country:US
Practice Address - Phone:662-231-2510
Practice Address - Fax:662-844-3333
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS07561208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery