Healthcare Provider Details

I. General information

NPI: 1407204233
Provider Name (Legal Business Name): THOMAS WHITTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 JEFFERSON ST
LAUREL MS
39440-4354
US

IV. Provider business mailing address

301 SEAPORT LN APT 2223
MT PLEASANT SC
29464-2937
US

V. Phone/Fax

Practice location:
  • Phone: 601-399-6169
  • Fax: 601-399-6184
Mailing address:
  • Phone: 248-990-2191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number37095
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberLL39535
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number04-49260
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: