Provider Demographics
NPI:1477571388
Name:JEFFREY W. THOMPSON, MD, PC
Entity Type:Organization
Organization Name:JEFFREY W. THOMPSON, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:BINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-973-1410
Mailing Address - Street 1:1901 W HAMILTON ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-6459
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:121 N CEDAR CREST BLVD
Practice Address - Street 2:SUITE F
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4664
Practice Address - Country:US
Practice Address - Phone:610-433-0246
Practice Address - Fax:610-433-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014786E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1566347OtherHIGHMARK BLUE SHIELD
PADB1085OtherPALMETTO GBA
PA50032027OtherCAPITAL BLUE CROSS
PAE61002Medicare UPIN
PA50032027OtherCAPITAL BLUE CROSS