Provider Demographics
NPI:1780777276
Name:BIESINGER, THOMAS Y (PT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:Y
Last Name:BIESINGER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16325
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-6325
Mailing Address - Country:US
Mailing Address - Phone:601-268-3292
Mailing Address - Fax:601-268-3290
Practice Address - Street 1:1 LINCOLN PARKWAY
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402
Practice Address - Country:US
Practice Address - Phone:601-268-3292
Practice Address - Fax:601-268-3290
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSPT0952225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS650000213OtherMEDICARE
MS00120318Medicaid
MSP00062875OtherRAILROAD MEDICARE