Healthcare Provider Details

I. General information

NPI: 1730176751
Provider Name (Legal Business Name): WILLIAM B. THOMPSON JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 SW 22ND PL
OCALA FL
34471-7765
US

IV. Provider business mailing address

2120 SW 22ND PL
OCALA FL
34471-7765
US

V. Phone/Fax

Practice location:
  • Phone: 352-732-5042
  • Fax: 352-732-6031
Mailing address:
  • Phone: 352-732-5042
  • Fax: 352-732-6031

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME0039566
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: