Healthcare Provider Details

I. General information

NPI: 1982664256
Provider Name (Legal Business Name): THOMAS CALVIN GARROTT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 09/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 MARKS ROAD
OCEAN SPRINGS MS
39564
US

IV. Provider business mailing address

24 MARKS ROAD
OCEAN SPRINGS MS
39564
US

V. Phone/Fax

Practice location:
  • Phone: 228-872-8873
  • Fax: 228-872-8876
Mailing address:
  • Phone: 228-872-8873
  • Fax: 228-872-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number5435
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: