Individual
JON DAVID THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5700
(601) 268-5777
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 268-5700
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
15365
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120227
—
MS
05
—
009932430
—
AL
01
—
1559110
AMERICAN ADMIN GROUP
MS
05
—
1739812
—
LA
Enumeration date
08/30/2006
Last updated
07/14/2020
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