MEDICARE: JONATHAN RICHARD 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	207P00000X	Emergency Medicine Physician	052646	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00233185	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4061474	OTHER	TN	BCBS OF TENNESSEE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982635462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN RICHARD THOMPSON MD

Provider Business Mailing Address
First Line	:	1107 MEMORIAL DR STE G2
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-8662
Country	:	US
Telephone Number	:	706-529-3245
Fax Number	:

Provider Business Practice Location Address
First Line	:	1107 MEMORIAL DR STE G2
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-8662
Country	:	US
Telephone Number	:	706-529-3245
Fax Number	:

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	05/07/2026

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