Provider Demographics
NPI:1629288279
Name:MILLS, THOMAS P (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:MILLS
Suffix:
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 1:970 LAKELAND DR
Mailing Address - Street 2:SUITE 49
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4634
Mailing Address - Country:US
Mailing Address - Phone:601-987-4463
Mailing Address - Fax:
Practice Address - Street 1:970 LAKELAND DR
Practice Address - Street 2:SUITE 49
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4634
Practice Address - Country:US
Practice Address - Phone:601-987-4463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS11853207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology