Provider Demographics
NPI:1629181425
Name:CABELL, THOMAS HARGRAVE (M D)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HARGRAVE
Last Name:CABELL
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3000 OLD CANTON RD
Mailing Address - Street 2:SUITE 405
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4200
Mailing Address - Country:US
Mailing Address - Phone:601-362-2332
Mailing Address - Fax:601-362-2436
Practice Address - Street 1:3000 OLD CANTON RD
Practice Address - Street 2:SUITE 405
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4200
Practice Address - Country:US
Practice Address - Phone:601-362-2332
Practice Address - Fax:601-362-2436
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MS06706207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS082945230OtherMEDICARE PTAN
MSB31167Medicare UPIN