Dr. Tommie Mack Granger
Cardiothoracic Vascular Surgeon
211 4th St Box 30163
Alexandria
, Louisiana 71301-8421
Dr. Tommie Mack Granger
Cardiothoracic Vascular Surgeon
211 4th St Box 30163
Alexandria
, Louisiana 71301-8421
(318) 767-5887
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Tommie Mack Granger
- 211 4th St Box 30163
- Alexandria, LA
- Zip : 71301-8421
- Fax : (318) 767-5887
- Phone : (318) 767-5878
Second Address
- Dr. Tommie Mack Granger
- 211 4th St Box 30163
- Alexandria, LA
- Zip : 71301-8421
- Fax : (318) 767-5887
- Phone : (318) 767-5878
Reviews
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 10146R | LA |
National Provider Identifier
| NPI | 1124018866 |
|---|---|
| Provider Name | Dr. Tommie Mack Granger |
| First Address | Alexandria, LA 71301-8421 |
| Second Address | Alexandria, LA 71301-8421 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/10/2005 |
| Last Update Date | 02/12/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 126445 | MISSISSIPPI MEDICAID (01) | MP |
| 1982067 | (05) | LA |
| F73521 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.