Provider Demographics
NPI:1730478074
Name:HESTER, THOMAS W (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:HESTER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2176 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-5981
Mailing Address - Country:US
Mailing Address - Phone:662-620-5027
Mailing Address - Fax:662-620-5077
Practice Address - Street 1:2176 S EASON BLVD
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-5981
Practice Address - Country:US
Practice Address - Phone:662-620-5027
Practice Address - Fax:662-620-5077
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT1058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist