Provider Demographics
NPI:1326113481
Name:THOMPSON NELSON, SUNNY N (MD)
Entity Type:Individual
Prefix:
First Name:SUNNY
Middle Name:N
Last Name:THOMPSON NELSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUNNY
Other - Middle Name:NOEL
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:150 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NY
Mailing Address - Zip Code:13346-9575
Mailing Address - Country:US
Mailing Address - Phone:315-684-3117
Mailing Address - Fax:315-684-9848
Practice Address - Street 1:3460 SOUTH ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NY
Practice Address - Zip Code:13408-9671
Practice Address - Country:US
Practice Address - Phone:315-684-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD27044207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine