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General NPI Number Information
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NPI Number | 1992742902
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Entity Type | Individual
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Provider Name | PAUL E. THOMPSON JR. MD
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Gender | Male
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Dates
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Enumeration Date | 05/31/2006
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 12 BOARDWALK PL SUITE 1A
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City | SENECA
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State | SC
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Zip | 29678-2671
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Country | US
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Telephone | 264-228-5933
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Fax | 264-225-9404
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Provider Business Mailing Address
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Address Line | PO BOX 2020
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City | SENECA
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State | SC
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Zip | 29679-2020
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Country | US
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Telephone | 864-882-5933
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Fax | 864-885-9404
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 16369
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License Number State | SC
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