Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 18174 | AL |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 25259 | MS |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 55970 | TN |
NPI | 1902807878 |
---|---|
Provider Name | Dr. Thomas Clifton Pitman |
First Address | Memphis, TN 38120-9446 |
Second Address | Southaven, MS 38671-5306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009937470 | (05) | AL |
F82447 | (02) |