Healthcare Provider Details

I. General information

NPI: 1427972694
Provider Name (Legal Business Name): RANDY ALAN THOMPSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2026
Last Update Date: 08/08/2026
Certification Date: 08/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

849 FAIRMOUNT AVE STE 200
TOWSON MD
21286-2693
US

IV. Provider business mailing address

849 FAIRMOUNT AVE STE 200 PMB 1000
TOWSON MD
21286
US

V. Phone/Fax

Practice location:
  • Phone: 410-978-7538
  • Fax:
Mailing address:
  • Phone: 410-978-7538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD486987
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: