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NPI Code Detail

MEDICARE: THOMAS THOMPSON PA

MEDICARE: THOMAS THOMPSON PA
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
1363A00000XPhysician AssistantPA9104121FL

Other Identifiers

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

General Provider Information

NPI Number : 1467665349
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS THOMPSON PA
Provider Business Mailing Address
First Line : PO BOX 2066
Second Line :
City : LECANTO
State : FL
Zip : 34460-2066
Country : US
Telephone Number : 352-563-0931
Fax Number :
Provider Business Practice Location Address
First Line : 1907 HIGHWAY 44 W
Second Line :
City : INVERNESS
State : FL
Zip : 34453-3801
Country : US
Telephone Number : 352-344-2273
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2007
Last Update Date : 10/18/2021

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Directions to “ THOMAS THOMPSON PA” Practice Location

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