NPIMap

Organization Active NPI

E Thomas Cullom III MD PLLC

Doing business as cullom, edward

  • Neurological Surgery Physician
  • Flowood, MS
National Provider Identifier
1326294158
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
11803 Issued in MS
Legal business name
E THOMAS CULLOM III MD PLLC
Doing business as
cullom, edward
Practice address
1029 River Oaks Dr
Flowood, MS 39232-9554
Phone
(601) 664-1000
Fax
(601) 664-2777
NPI assigned
Aug 12, 2008
Last updated
Dec 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward Thomas Cullom III, MDNPI 1710997135
Title
Manager
Phone
(601) 664-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 11803 MS Primary

Addresses

Primary practice location

1029 River Oaks Dr
Flowood, MS 39232-9554

Mailing address

1029 River Oaks Dr
Flowood, MS 39232-9554
Phone (601) 664-1000

Other identifiers 1

IdentifierTypeStateIssuer
01409383MedicaidMS

Other names 1

  • cullom, edward Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575417600000",
    "number": "1326294158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329554",
            "telephone_number": "601-664-1000",
            "fax_number": "601-664-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 RIVER OAKS DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392329554",
            "telephone_number": "601-664-1000",
            "fax_number": "601-664-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E THOMAS CULLOM III MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2019-12-04",
        "status": "A",
        "authorized_official_last_name": "CULLOM",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-664-1000",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MS",
            "license": "11803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01409383",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "cullom, edward",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.