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Individual

THOMAS STALLWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ARNP

Contact information

Practice address
3980G AIRPORT BLVD, MOBILE, AL 36608-2224
(251) 318-2603
(251) 318-2604
Mailing address
4105 HOSPITAL ST STE 104, PASCAGOULA, MS 39581-5312
(228) 762-9595
(287) 629-4942

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-114845
AL
363LP0200X
Pediatric Nurse Practitioner
902668
MS
363LP0200X
Pediatric Nurse Practitioner
9331690
FL

Other

Enumeration date
03/31/2014
Last updated
10/19/2021
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