Individual
MS. TOMIEKO THREADGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHLEBO, MA, CMLA
Contact information
Practice address
549 E PASS RD STE J, GULFPORT, MS 39507-3261
(228) 284-4176
(228) 284-5724
Mailing address
549 E PASS RD STE J, GULFPORT, MS 39507-3261
(228) 284-4176
(228) 284-5724
Taxonomy
Speciality
Code
Description
License number
State
246RM2200X
Medical Laboratory Technician
279306
MS
246RP1900X
Phlebotomy Technician
Primary
279306
MS
247ZC0005X
Clinical Laboratory Director (Non-physician)
25D2232943
MS
291U00000X
Clinical Medical Laboratory
25D2232943
MS
374700000X
Technician
279306
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002200921
—
MS
Enumeration date
06/30/2020
Last updated
07/22/2024
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