Healthcare Provider Details

I. General information

NPI: 1003032046
Provider Name (Legal Business Name): CHRISTOPHER SANFORD THOMPSON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 01/02/2026
Certification Date: 01/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 GOLD STAR HWY STE 201
GROTON CT
06340-6702
US

IV. Provider business mailing address

1869 SOMERSBY LN
VIRGINIA BEACH VA
23456-7836
US

V. Phone/Fax

Practice location:
  • Phone: 860-445-8020
  • Fax: 860-445-1665
Mailing address:
  • Phone: 757-462-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: