MEDICARE: DR. ADAM THOMPSON DMD

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
1	122300000X	Dentist	08132	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245287226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADAM THOMPSON DMD

Provider Business Mailing Address
First Line	:	203 CHAMPION WAY
Second Line	:	SUITE 6
City	:	GEORGETOWN
State	:	KY
Zip	:	40324-8861
Country	:	US
Telephone Number	:	502-868-5999
Fax Number	:	502-868-5944

Provider Business Practice Location Address
First Line	:	2909 RICHMOND RD STE 30
Second Line	:
City	:	LEXINGTON
State	:	KY
Zip	:	40509-1715
Country	:	US
Telephone Number	:	859-268-4402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	12/17/2019

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