Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 22511 | MS |
Y | 208600000X | Surgeon | 22511 | MS |
N | 2082S0105X | Plastic Hand Surgeon | 22511 | MS |
N | 2086S0122X | Plastic and Reconstructive Surgery | 304799 | LA |
NPI | 1265698195 |
---|---|
Provider Name | Dr. Michael Thomas Friel |
First Address | Jackson, MS 39216-4500 |
Second Address | Jackson, MS 39216-4500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2008 |
Last Update Date | 05/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
06182000 | (05) | MS |
194857 | (05) | AL |
P01788013 | RR MEDICARE (01) | MS |