Provider Demographics
NPI:1285711457
Name:TP FAMILY ASSOCIATES
Entity type:Organization
Organization Name:TP FAMILY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSCIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRAFTON
Authorized Official - Suffix:SR
Authorized Official - Credentials:DO
Authorized Official - Phone:662-562-7503
Mailing Address - Street 1:4364 HIGHWAY 51 S
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-2534
Mailing Address - Country:US
Mailing Address - Phone:662-562-7503
Mailing Address - Fax:662-562-0026
Practice Address - Street 1:4364 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2534
Practice Address - Country:US
Practice Address - Phone:662-562-7503
Practice Address - Fax:662-562-0026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12613207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07170387Medicaid
MS00120456Medicaid
MS07170387Medicaid