MEDICARE: CHARLES ARMISTEAD THOMPSON MD

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	207RP1001X	Pulmonary Disease Physician	17521	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	8607	OTHER	SC	MEDICARE GROUP NUMBER

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	P00944916	OTHER	SC	RR MEDICIARE

General Provider Information

NPI Number	:	1851394597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLES ARMISTEAD THOMPSON MD

Provider Business Mailing Address
First Line	:	PO BOX 4145
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29622-4145
Country	:	US
Telephone Number	:	864-540-8025
Fax Number	:	864-540-8027

Provider Business Practice Location Address
First Line	:	1214 N FANT ST STE B
Second Line	:
City	:	ANDERSON
State	:	SC
Zip	:	29621-4822
Country	:	US
Telephone Number	:	864-540-8025
Fax Number	:	864-540-8027

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

Provider Enumeration Date	:	05/26/2005
Last Update Date	:	09/16/2022

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Directions to “ CHARLES ARMISTEAD THOMPSON MD” Practice Location

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