Provider Demographics
NPI:1073653341
Name:THOMPSON, WILLIAM ROY (DPT)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ROY
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 GILLESPIE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-8361
Mailing Address - Country:US
Mailing Address - Phone:302-378-7216
Mailing Address - Fax:
Practice Address - Street 1:053 MCKINLY LABORATORY
Practice Address - Street 2:UNIVERSITY OF DELAWARE
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19716
Practice Address - Country:US
Practice Address - Phone:302-831-8893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJT-0000631225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist