Healthcare Provider Details

I. General information

NPI: 1447291760
Provider Name (Legal Business Name): JAMES M. THOMPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 04/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LIBERTY ST SUITE 800
LOUISVILLE KY
40202-1434
US

IV. Provider business mailing address

1021 MAJESTIC DRIVE SUITE 200
LEXINGTON KY
40513
US

V. Phone/Fax

Practice location:
  • Phone: 606-330-7818
  • Fax: 606-330-7825
Mailing address:
  • Phone: 859-296-1922
  • Fax: 859-685-0701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0600X
TaxonomyClinical Neurophysiology Physician
License Number22763
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number22763
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number22763
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: