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General NPI Number Information
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NPI Number | 1730292236
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Entity Type | Individual
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Provider Name | JAMES T. THOMPSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 3 RIVERSIDE CIR
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City | ROANOKE
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State | VA
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Zip | 24016-4955
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Country | US
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Telephone | 540-224-5170
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Fax |
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Provider Business Mailing Address
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Address Line | 213 S JEFFERSON ST STE 1006
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City | ROANOKE
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State | VA
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Zip | 24011-1713
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Country | US
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Telephone |
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Fax |
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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 | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | 9901624
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 9901624
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 9901624
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 0101259658
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License Number State | VA
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