Healthcare Provider Details

I. General information

NPI: 1982917431
Provider Name (Legal Business Name): THOMPSON EYE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2010
Last Update Date: 11/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 COOLIDGE RD SUITE 15
EAST LANSING MI
48823-1363
US

IV. Provider business mailing address

2200 COOLIDGE RD SUITE 15
EAST LANSING MI
48823-1363
US

V. Phone/Fax

Practice location:
  • Phone: 517-977-1598
  • Fax: 517-977-1785
Mailing address:
  • Phone: 517-977-1598
  • Fax: 517-977-1785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number4901003790
License Number StateMI

VIII. Authorized Official

Name: DR. STEPHEN P THOMPSON
Title or Position: PRESIDENT
Credential: OD
Phone: 517-977-1598