MEDICARE: THOMPSON SURGICAL ASSOCIATES INC

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	208600000X	Surgery Physician	20628	AL

General Provider Information

NPI Number	:	1821170218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMPSON SURGICAL ASSOCIATES INC

Provider Business Mailing Address
First Line	:	317 MEDICAL CENTER DR SW
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35968-3420
Country	:	US
Telephone Number	:	256-845-3336
Fax Number	:	256-845-3686

Provider Business Practice Location Address
First Line	:	317 MEDICAL CENTER DR SW
Second Line	:
City	:	FORT PAYNE
State	:	AL
Zip	:	35968-3420
Country	:	US
Telephone Number	:	256-845-3336
Fax Number	:	256-845-3686

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JEFFREY HALL THOMPSON
Credential	:	M.D.
Telephone Number	:	256-845-3336

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	08/22/2020

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