DR. THOMAS D FOWLKES (NPI# 1477649218) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477649218 |
| Entity Type | Individual |
| Full Name | DR. THOMAS D FOWLKES |
| Credential | M. D. |
| Practice Address |
1916 University Ave Oxford MS 38655-4114 |
| Mailing Address |
Po Box 1093 Oxford MS 38655-1093 |
| Practice Telephone | 6622811306 |
| Practice Fax Number | 6622811326 |
| Mailing Telephone | 6628017508 |
| Mailing Fax Number | 6622348531 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2012-07-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 13406 | MS | Allopathic & Osteopathic Physicians |
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
13406 | MS | Allopathic & Osteopathic Physicians |
| N | 208D00000X | General Practice | 13406 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | CIGNA PIN | 5916714 | 01 |
| MS | 01508551 | 05 |
| Street Address |
1916 UNIVERSITY AVE |
| City | OXFORD |
| State | MS |
| Zip Code | 38655-4114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245747526 | Brian Simmons | Social Worker | 1916 University Ave, Oxford, MS 38655-4114 | 2018-01-08 |
| 1659883155 | Marcelene Kubacki Redding | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2017-10-25 |
| 1548799000 | Deja Jawanda Washington | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2017-06-08 |
| 1215476569 | Martinese Fitzpatrick | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2017-02-20 |
| 1487193884 | Larry R. Wills | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2017-02-17 |
| 1649635111 | Emily Grace Ames | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2015-12-28 |
| 1841661899 | Autum Pierce | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2015-10-16 |
| 1619353877 | Oxford Treatment Center, LLC | Clinic/Center | 1916 University Ave, Oxford, MS 38655-4114 | 2015-08-10 |
| 1720404916 | Doris Meux | Counselor | 1916 University Ave, Oxford, MS 38655-4114 | 2014-03-12 |
| 1477817526 | Oxford Centre Physician Group, P.a. | Psychologist | 1916 University Ave, Oxford, MS 38655-4114 | 2012-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619585809 | Oxford Treatment Center, LLC | Substance Abuse Rehabilitation Facility | 616 Commerce Parkway, Oxford, MS 38655 | 2020-07-14 |
| 1760044465 | Lindsay Low Beauchamp | Speech-Language Pathologist | 169 Ms-6 #102, Oxford, MS 38655 | 2019-07-02 |
| 1861058075 | Tomiko D Mackey | Social Worker | 100 Carriage Cove, Oxford, MS 38655 | 2019-05-13 |
| 1174090039 | Derionne Brooks | Specialist/Technologist | 972 Hathorn Road, University, MS 38655 | 2018-10-30 |
| 1497236327 | Providence Companion Care | Nurse's Aide | 317 Heritage Dr Ste 3b, Oxford, MS 38655 | 2018-08-28 |
| 1255817292 | Marcela Caroline Weber | Counselor | 152 Mississippi 7 South, Oxford, MS 38655 | 2018-07-12 |
| 1649775123 | Oxford Outpatient Center, LLC | Clinic/Center | 611 Commerce Pkwy, Oxford, MS 38655 | 2018-03-27 |
| 1073039962 | Sharon Yvette Holloway | Social Worker | 152 Hwy and South, Oxford, Ms 38655, Oxford, MS 38655 | 2017-08-22 |
| 1447774682 | Courtney M Purvis | Physical Therapist | 300 Enterprise Dr Ste B, Oxford, MS 38655 | 2017-07-31 |
| 1649716580 | Taylor Lynn Smith | Counselor | 152 Ms-7, Oxford, MS 38655 | 2017-01-17 |
| Find all providers in zip 38655 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164518874 | John Thomas Barringer | Internal Medicine | 1551 E County Line Rd, Jackson, MS 39211-1801 | 2006-10-04 |
| 1730289802 | Lloyd James Gordon IIi | Internal Medicine | 3949 Highway 43 N, Brandon, MS 39047-7240 | 2006-09-25 |
| 1306840871 | William R. Fellows, Md | Internal Medicine | 180 Debuys Rd, Ste 130, Biloxi, MS 39531-4402 | 2005-06-11 |
| 1104117688 | Gerald B Broussard Jr. | Internal Medicine | 6051 U S Highway 49, Hattiesburg, MS 39401-7200 | 2011-05-02 |
| 1699897066 | Carl Alvin Faulks | Internal Medicine | 450 E Pass Rd, Suite 3, Gulfport, MS 39507-3212 | 2007-04-04 |
| 1396814794 | James J Kramer | Internal Medicine | 405 Fontaine Pl, Suite 101, Ridgeland, MS 39157-5228 | 2006-11-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.