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General NPI Number Information
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NPI Number | 1174576730
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Entity Type | Individual
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Provider Name | TOMMIE BRIAN STRETCH M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 55 SERGEANT PRENTISS DR SUITE 7
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City | NATCHEZ
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State | MS
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Zip | 39120-4782
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Country | US
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Telephone | 601-445-9543
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Fax | 601-445-9803
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Provider Business Mailing Address
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Address Line | 55 SGT PRENTISS DR
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City | NATCHEZ
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State | MS
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Zip | 39120-4740
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Country | US
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Telephone | 601-445-9543
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Fax | 601-445-9803
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 12805
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 019243
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101283243
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License Number State | VA
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