Thipavan Boone, M.D.

Individual provider Active NPI Diagnostic Radiology Physician · Cleveland, MS

NPI 1881780286 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1881780286
Entity type
Individual (NPI type 1)
Primary specialty
Diagnostic Radiology Physician 2085R0202X
License
09550 (MS)
Practice address
901 East Sunflower Road
Cleveland, MS 38732
Phone
(662) 846-0061
Fax
(662) 846-2380
NPI assigned
Oct 4, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Regional Medical System Past Accepting new patients
PHC-Cleveland LLC Diagnostic Radiology Past Accepting new patients
Rad-One, PA Diagnostic Radiology Past Accepting new patients
Greenwood Leflore Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 09550 MS Yes

Addresses

Primary practice location

901 East Sunflower Road
Cleveland, MS 38732

Mailing address

8910 Forest Ridge Cove
Cordova, TN 38018
Phone (901) 751-8153

Other providers in Cleveland, MS

All providers in Cleveland, MS · Diagnostic Radiology Physician in Mississippi

Sources for this page

Verify at the official NPI Registry.