Provider Demographics
NPI:1497710123
Name:THOMPSON, HORACE BIRTRUDE (MD)
Entity Type:Individual
Prefix:DR
First Name:HORACE
Middle Name:BIRTRUDE
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 1:100 MEDICAL CENTER DR
Mailing Address - Street 2:STE. 207
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35903-1134
Mailing Address - Country:US
Mailing Address - Phone:256-492-4001
Mailing Address - Fax:256-492-4031
Practice Address - Street 1:100 MEDICAL CENTER DR
Practice Address - Street 2:STE. 207
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35903-1134
Practice Address - Country:US
Practice Address - Phone:256-492-4001
Practice Address - Fax:256-492-4031
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2009-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL6370207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051558153Medicaid
AL515-95271OtherAL BCBS
AL1497710123 / 109273Medicaid
AL510I110390Medicare PIN
AL051558153Medicaid
ALP00703802Medicare PIN