MEDICARE: DR. PATTI LYNETTE THOMPSON DPM

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
1	213E00000X	Podiatrist	478	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	081AE	OTHER	NC	BCBS

General Provider Information

NPI Number	:	1790863496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATTI LYNETTE THOMPSON DPM

Provider Business Mailing Address
First Line	:	PO BOX 124
Second Line	:
City	:	HILLSBOROUGH
State	:	NC
Zip	:	27278-0124
Country	:	US
Telephone Number	:	919-732-4860
Fax Number	:	919-732-9341

Provider Business Practice Location Address
First Line	:	101 E CORBIN ST
Second Line	:
City	:	HILLSBOROUGH
State	:	NC
Zip	:	27278-2104
Country	:	US
Telephone Number	:	919-644-1111
Fax Number	:	919-644-2111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	07/09/2007

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