Provider Demographics
NPI:1396857090
Name:THOMPSON, HAROLD DELANE (MD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:DELANE
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6326 CANTERBURY CLOSE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-4870
Mailing Address - Country:US
Mailing Address - Phone:615-371-9616
Mailing Address - Fax:615-321-6322
Practice Address - Street 1:1310 24TH AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2637
Practice Address - Country:US
Practice Address - Phone:615-327-5369
Practice Address - Fax:615-321-6322
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN123252085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3036162Medicaid
TNA99973Medicare UPIN