Provider Demographics
NPI:1477965812
Name:THOMPKINS, JEFFERY EUGENE JR
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:EUGENE
Last Name:THOMPKINS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 N DECATUR BLVD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-2975
Mailing Address - Country:US
Mailing Address - Phone:702-982-3636
Mailing Address - Fax:702-982-3737
Practice Address - Street 1:2525 N DECATUR BLVD
Practice Address - Street 2:SUITE 2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89108-2975
Practice Address - Country:US
Practice Address - Phone:702-982-3636
Practice Address - Fax:702-982-3737
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst