Healthcare Provider Details

I. General information

NPI: 1831199033
Provider Name (Legal Business Name): NANCY SUE THOMPSON M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MRS. NANCY SUE BENNISH

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 SHRINE RD STE 270
BRUNSWICK GA
31520-4785
US

IV. Provider business mailing address

3025 SHRINE RD STE 270
BRUNSWICK GA
31520-4785
US

V. Phone/Fax

Practice location:
  • Phone: 912-262-2723
  • Fax: 877-244-5666
Mailing address:
  • Phone: 912-262-2723
  • Fax: 877-244-5666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number050065
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: