Provider Demographics
NPI:1457490849
Name:THOMPSON, MICHAEL BRYANT (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRYANT
Last Name:THOMPSON
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1321 13TH ST N
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-2613
Mailing Address - Country:US
Mailing Address - Phone:502-425-6690
Mailing Address - Fax:502-425-6629
Practice Address - Street 1:4201 SPRINGHURST BLVD
Practice Address - Street 2:SUITE 203
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-6155
Practice Address - Country:US
Practice Address - Phone:502-425-6690
Practice Address - Fax:502-425-6629
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2016-06-09
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Provider Licenses
StateLicense IDTaxonomies
KY425052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry