Healthcare Provider Details

I. General information

NPI: 1578624342
Provider Name (Legal Business Name): JOHN DEREK THOMPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 SW 46TH CT
OCALA FL
34474-5708
US

IV. Provider business mailing address

4600 SW 46TH CT
OCALA FL
34474-5708
US

V. Phone/Fax

Practice location:
  • Phone: 352-629-1800
  • Fax: 352-629-1888
Mailing address:
  • Phone: 352-629-1800
  • Fax: 352-629-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberME51022
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: