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Individual

JAMES C THRIFFILEY IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1639 E PASS RD, GULFPORT, MS 39507
(228) 822-2663
(228) 604-2255
Mailing address
1639 E PASS RD, GULFPORT, MS 39507-3542
(228) 822-2663
(228) 604-2255

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
15285
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00127085
MS
01
1568410058
GROUP DME NPI
MS
01
DA3947
MEDICARE RR
MS
Enumeration date
07/18/2005
Last updated
05/29/2018
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