Provider Demographics
NPI:1417010075
Name:THOMPSON PLASTIC SURGERY ASSOCIATES, LLC
Entity Type:Organization
Organization Name:THOMPSON PLASTIC SURGERY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD CERTIFIED PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-698-0888
Mailing Address - Street 1:18 WASHINGTON ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FOXBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02035-1021
Mailing Address - Country:US
Mailing Address - Phone:508-698-0888
Mailing Address - Fax:508-698-0889
Practice Address - Street 1:18 WASHINGTON ST
Practice Address - Street 2:SUITE 201
Practice Address - City:FOXBORO
Practice Address - State:MA
Practice Address - Zip Code:02035-1021
Practice Address - Country:US
Practice Address - Phone:508-698-0888
Practice Address - Fax:508-698-0889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA209748208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA5967055OtherCIGNA
RI413768OtherBLUECHIP
MAM19277OtherBLUE CROSS MA
RI31896-5OtherBLUE SHIELD
MA419335OtherTUFTS
MA608893OtherFALLON COM. HEALTH PLAN
MA11167384OtherCAQH
MA0143880Medicaid
MAAA70338OtherHARVARD PILGRIM
RI31896-5OtherBLUE SHIELD
RI413768OtherBLUECHIP