Provider Demographics
NPI:1346276425
Name:THOMPSON, ERIC DOUGLAS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:DOUGLAS
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:765 PALMER PL
Mailing Address - Street 2:
Mailing Address - City:BLUE BELL
Mailing Address - State:PA
Mailing Address - Zip Code:19422-1724
Mailing Address - Country:US
Mailing Address - Phone:215-654-8377
Mailing Address - Fax:215-427-5371
Practice Address - Street 1:ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
Practice Address - Street 2:ERIE AVENUE & FRONT STREET
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-4308
Practice Address - Fax:215-427-5371
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD055689L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015877570005Medicaid
PAG35413Medicare UPIN
PA0015877570005Medicaid