Tommaso Agostino, DO

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Laurel, MS

NPI 1184428070 · NPPES record last updated Apr 1, 2025

Key facts

NPI
1184428070
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1220 Jefferson St # 607
Laurel, MS 39440-4355
Phone
(601) 426-4000
NPI assigned
Apr 1, 2025
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20251204004086 MS Order and Referring Only - Internal Medicine
Practitioner - Internal Medicine
2264925585

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1220 Jefferson St # 607
Laurel, MS 39440-4355

Mailing address

1220 Jefferson St # 607
Laurel, MS 39440-4355

Other providers in Laurel, MS

All providers in Laurel, MS · Student in an Organized Health Care Education/Training Program in Mississippi

Sources for this page

Verify at the official NPI Registry.