1689768434 NPI number — THOMAS OLIVER MCRANEY M.D.

Table of content: THOMAS OLIVER MCRANEY M.D. (NPI 1689768434)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689768434 NPI number — THOMAS OLIVER MCRANEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCRANEY
Provider First Name:
THOMAS
Provider Middle Name:
OLIVER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689768434
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1018 SIXTH AVE
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
PICAYUNE
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39466-3837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-799-1901
Provider Business Mailing Address Fax Number:
601-799-1906

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1018 SIXTH AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
PICAYUNE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39466-3837
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-799-1901
Provider Business Practice Location Address Fax Number:
601-799-1906
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  7686 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00016244 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01-30218 . This is a "UNITED HEALTHCARE MS" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 10538 . This is a "BLUE CROSS BLUE SHIELD LA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".
  • Identifier: 1181102 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01-1002-8 . This is a "UNITED HEALTHCARE LA" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com