Provider Demographics
NPI:1386663144
Name:THOMPSON, THOMAS A (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
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 1:4323 CAROTHERS PKWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5914
Mailing Address - Country:US
Mailing Address - Phone:615-565-6634
Mailing Address - Fax:615-565-6677
Practice Address - Street 1:4323 CAROTHERS PKWY
Practice Address - Street 2:SUITE 308
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5914
Practice Address - Country:US
Practice Address - Phone:615-565-6634
Practice Address - Fax:615-565-6677
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS08441207RC0000X
TN44301207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1509837Medicaid
MS00115626Medicaid
TN3002520Medicare PIN
TN1509837Medicaid
MSB31163Medicare UPIN
060021370Medicare PIN