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1164499190
THOMAS P FORKS
JACKSON, MS
NPI
1164499190
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MS 12215)
Enumeration Date
2006-03-08
Last Update Date
2010-12-02
Business Address
-- THOMAS P FORKS DO
7275 S SIWELL RD
JACKSON, MS 39272-9776
Phone number: 601-373-7722
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Mailing Address
-- THOMAS P FORKS DO
1151 N STATE ST SUITE 408
JACKSON, MS 39202-2407
Phone number: 601-292-4261
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