Provider Demographics
NPI:1003447327
Name:THOMPSON, ORLANDO
Entity Type:Individual
Prefix:
First Name:ORLANDO
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12409 LARGO DR APT 78
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-2048
Mailing Address - Country:US
Mailing Address - Phone:912-655-8945
Mailing Address - Fax:
Practice Address - Street 1:7219 SEAWRIGHT DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2703
Practice Address - Country:US
Practice Address - Phone:912-355-7633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-27
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral