Individual
THOMAS L GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 865-3151
(228) 867-4124
Mailing address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 865-3151
(228) 867-4124
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
07008
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119507
—
MS
Enumeration date
10/19/2006
Last updated
07/08/2007
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