Provider Demographics
NPI:1962476077
Name:JAMISON, THOMAS SCOTT (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:SCOTT
Last Name:JAMISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1690 US HIGHWAY1 S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-7037
Mailing Address - Country:US
Mailing Address - Phone:910-684-5499
Mailing Address - Fax:910-684-5567
Practice Address - Street 1:1690 US HIGHWAY 1 S
Practice Address - Street 2:SUITE 300
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-7037
Practice Address - Country:US
Practice Address - Phone:910-684-5499
Practice Address - Fax:910-684-5567
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-00797207R00000X, 202D00000X
MO2019005174207R00000X
IL036.156348207R00000X
VA0101047305207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202D00000XAllopathic & Osteopathic PhysiciansIntegrative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
C17399Medicare UPIN
VA00X159C01Medicare PIN
P00361714Medicare PIN