Healthcare Provider Details

I. General information

NPI: 1982145108
Provider Name (Legal Business Name): JOSHUA A THOMPSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6845 ELM ST STE 303
MC LEAN VA
22101-3834
US

IV. Provider business mailing address

523 LONGFELLOW ST NW UNIT 2
WASHINGTON DC
20011-3013
US

V. Phone/Fax

Practice location:
  • Phone: 703-448-0005
  • Fax:
Mailing address:
  • Phone: 716-435-4181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberD0094939
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number0101278964
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: