Provider Demographics
NPI:1467683300
Name:THOMPSON, SETH CLAYTON (MD)
Entity Type:Individual
Prefix:DR
First Name:SETH
Middle Name:CLAYTON
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 1:108 FURCHES DR APT 14
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37615-6712
Mailing Address - Country:US
Mailing Address - Phone:407-361-0754
Mailing Address - Fax:
Practice Address - Street 1:108 FURCHES DR APT 14
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37615-6712
Practice Address - Country:US
Practice Address - Phone:407-361-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012504142084A0401X, 2084P0800X, 2084P0802X
PAMD4794002084A0401X, 2084P0800X
TN505382084P0800X, 2084A0401X
TN00000505382084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry