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NPI Code Detail

MEDICARE: DR. JANNAH HILARY THOMPSON M.D.

MEDICARE: DR. JANNAH HILARY THOMPSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology Physician4301095660MI
2207VF0040XUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician4301095660MI

General Provider Information

NPI Number : 1104089986
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JANNAH HILARY THOMPSON M.D.
Provider Business Mailing Address
First Line : PO BOX 776982
Second Line :
City : CHICAGO
State : IL
Zip : 60677-6982
Country : US
Telephone Number : 231-672-2119
Fax Number :
Provider Business Practice Location Address
First Line : 6401 PRAIRIE ST STE 1700
Second Line :
City : NORTON SHORES
State : MI
Zip : 49444-7843
Country : US
Telephone Number : 231-672-7944
Fax Number : 231-672-7994
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2008
Last Update Date : 05/06/2025

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