Provider Demographics
NPI:1558389940
Name:THOMPSON, JAMES ARTHUR (CNS/PMH NP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ARTHUR
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:CNS/PMH NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 US HIGHWAY 84 W
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-0510
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:401 OLD ALBANY RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4014
Practice Address - Country:US
Practice Address - Phone:229-228-8100
Practice Address - Fax:229-228-8154
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN077718 CNS/PMH NP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00744202AMedicaid
GA00744202AMedicaid
GAS18525Medicare UPIN