Healthcare Provider Details

I. General information

NPI: 1497680771
Provider Name (Legal Business Name): THOMAS WEBER PT, DPT, CSCS, UDN-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2608 S LAMAR BLVD STE 102
OXFORD MS
38655-5243
US

IV. Provider business mailing address

140 BOATWRIGHT LN
PONTOTOC MS
38863-8685
US

V. Phone/Fax

Practice location:
  • Phone: 901-759-3111
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT8169
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: