Healthcare Provider Details
I. General information
NPI: 1568464709
Provider Name (Legal Business Name): THOMPSON FAMILY MEDICAL CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19144 US HIGHWAY 29
CHATHAM VA
24531-5253
US
IV. Provider business mailing address
19144 US HIGHWAY 29
CHATHAM VA
24531-5253
US
V. Phone/Fax
- Phone: 434-432-0216
- Fax:
- Phone: 434-432-0216
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 0101014610 |
| License Number State | VA |
VIII. Authorized Official
Name:
MARTHA
FARMER
ADKINS
Title or Position: OFFICE MANAGER
Credential:
Phone: 434-432-0216