Provider Demographics
NPI:1033105283
Name:THOMPSON, TIM J (OD)
Entity Type:Individual
Prefix:DR
First Name:TIM
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 18TH ST S STE 601
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-3800
Mailing Address - Country:US
Mailing Address - Phone:205-933-6888
Mailing Address - Fax:205-933-6421
Practice Address - Street 1:700 18TH ST S STE 601
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-3800
Practice Address - Country:US
Practice Address - Phone:205-325-8620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS784TA393152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51501411OtherBCBS
AL528500580Medicaid
AL051501411Medicare ID - Type Unspecified
AL528500580Medicaid
U47778Medicare UPIN
AL1780751040Medicare NSC
AL1063421261Medicare NSC
E376Medicare PIN