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NPI Code Detail

MEDICARE: ZACHARY PAUL THOMPSON DO

MEDICARE: ZACHARY PAUL THOMPSON DO
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
1207Q00000XFamily Medicine Physician89999GA

General Provider Information

NPI Number : 1710509674
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY PAUL THOMPSON DO
Provider Business Mailing Address
First Line : 1061 HARMON AVE
Second Line :
City : FORT STEWART
State : GA
Zip : 31314-5641
Country : US
Telephone Number : 912-435-6965
Fax Number :
Provider Business Practice Location Address
First Line : 1061 HARMON AVE
Second Line :
City : FORT STEWART
State : GA
Zip : 31314-5641
Country : US
Telephone Number : 912-435-6965
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2020
Last Update Date : 06/01/2026

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