Provider Demographics
NPI:1073720355
Name:THOMPSON, GREG R (MD)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:R
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 POND RD
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-3946
Mailing Address - Country:US
Mailing Address - Phone:603-770-7737
Mailing Address - Fax:603-382-0386
Practice Address - Street 1:31 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLAISTOW
Practice Address - State:NH
Practice Address - Zip Code:03865
Practice Address - Country:US
Practice Address - Phone:603-382-4741
Practice Address - Fax:603-382-0386
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH67202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry