Provider Demographics
NPI:1922132323
Name:CAREY, THOMAS EDWARDS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARDS
Last Name:CAREY
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 1:5052 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-1069
Mailing Address - Country:US
Mailing Address - Phone:601-261-2587
Mailing Address - Fax:601-264-7426
Practice Address - Street 1:5052 W 4TH ST
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-1069
Practice Address - Country:US
Practice Address - Phone:601-261-2587
Practice Address - Fax:601-264-7426
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9557207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0030515Medicaid
MT0030515Medicaid
MT220030015Medicare PIN
MT000081741Medicare PIN