Provider Demographics
NPI:1083723837
Name:THOMPSON, JOSEPH D JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1651
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2093 HENRY TECKLENBURG DR
Practice Address - Street 2:STE 201
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414
Practice Address - Country:US
Practice Address - Phone:843-958-2500
Practice Address - Fax:843-958-2635
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC5111207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00615384OtherRAILROAD MEDICARE
SCP00843990OtherRAILROAD MEDICARE ID-RSFPN
SC051115Medicaid
SCC610809223Medicare PIN
SC051115Medicaid
C61080Medicare UPIN