Healthcare Provider Details

I. General information

NPI: 1467886937
Provider Name (Legal Business Name): THOMAS POSEY FISHER NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2013
Last Update Date: 12/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 E FIFTEENTH ST
YAZOO CITY MS
39194-7607
US

IV. Provider business mailing address

1474 DOVER RD
BENTONIA MS
39040-9162
US

V. Phone/Fax

Practice location:
  • Phone: 662-746-6083
  • Fax: 662-746-1954
Mailing address:
  • Phone: 662-755-8657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR850302
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: