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NPI Code Detail

MEDICARE: DR. JACQUELINE THOMPSON M.D.

MEDICARE: DR. JACQUELINE THOMPSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12083P0011XUndersea and Hyperbaric Medicine (Preventive Medicine) Physician38994NC
2208600000XSurgery Physician1156VI

General Provider Information

NPI Number : 1255328753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACQUELINE THOMPSON M.D.
Provider Business Mailing Address
First Line : 100 AIRPORT RD
Second Line :
City : KINSTON
State : USVI
Zip : 28501-1604
Country : UM
Telephone Number : 340-332-2401
Fax Number :
Provider Business Practice Location Address
First Line : INTEGRATED WOUND SPECIALIST OF NORTH CAROLINA, PLLC
Second Line : 100 AIRPORT RD
City : KINSTON
State : NC - NORTH CAROLINA
Zip : 28501-1604
Country : UM
Telephone Number : 252-775-5920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2005
Last Update Date : 07/21/2022

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