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General NPI Number Information
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NPI Number | 1942251855
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Entity Type | Individual
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Provider Name | MATTHEW THOMPSON DPM
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Gender | Male
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 4850 FAYETTEVILLE RD
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City | LUMBERTON
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State | NC
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Zip | 28358-2100
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Country | US
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Telephone | 910-738-4811
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Fax | 910-738-7212
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Provider Business Mailing Address
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Address Line | 1738 METROMEDICAL DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3861
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Country | US
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Telephone | 910-484-4191
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Fax | 910-484-5546
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 158
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License Number State | NC
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