Healthcare Provider Details

I. General information

NPI: 1649279175
Provider Name (Legal Business Name): WILLIAM HAL THOMPSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 S LEWIS ST
TABOR CITY NC
28463-2316
US

IV. Provider business mailing address

404 S LEWIS ST
TABOR CITY NC
28463-2316
US

V. Phone/Fax

Practice location:
  • Phone: 910-653-3242
  • Fax: 910-653-2304
Mailing address:
  • Phone: 910-653-3242
  • Fax: 910-653-2304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1222
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: