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General NPI Number Information
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NPI Number | 1134212947
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Entity Type | Individual
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Provider Name | JEREMY R THOMPSON MD
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 11/28/2022
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Provider Practice Location Address
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Address Line | 1400 W MARKHAM ST STE 407
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City | LITTLE ROCK
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State | AR
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Zip | 72201-1844
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Country | US
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Telephone | 501-319-4819
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Fax | 501-897-6195
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Provider Business Mailing Address
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Address Line | 1400 W MARKHAM ST STE 407
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City | LITTLE ROCK
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State | AR
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Zip | 72201-1844
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Country | US
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Telephone | 501-319-4819
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Fax | 501-897-6195
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | E-5837
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 2006018429
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License Number State | MO
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