MEDICARE: THOMAS C GARROTT, M.D., PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	05435	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CD3311	OTHER	MS	MEDICARE RAIL ROAD

General Provider Information

NPI Number	:	1609080423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS C GARROTT, M.D., PA

Provider Business Mailing Address
First Line	:	PO BOX 789
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39566-0789
Country	:	US
Telephone Number	:	228-818-0563
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 MARKS RD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-4350
Country	:	US
Telephone Number	:	228-818-0563
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS GARRETT
Credential	:	MD
Telephone Number	:	228-818-0563

Provider Enumeration Date	:	05/10/2007
Last Update Date	:	06/26/2008

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