Provider Demographics
NPI:1568464709
Name:THOMPSON FAMILY MEDICAL CENTER, PC
Entity Type:Organization
Organization Name:THOMPSON FAMILY MEDICAL CENTER, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:FARMER
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-432-0216
Mailing Address - Street 1:19144 US HIGHWAY 29
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:VA
Mailing Address - Zip Code:24531-5253
Mailing Address - Country:US
Mailing Address - Phone:434-432-0216
Mailing Address - Fax:
Practice Address - Street 1:19144 US HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:VA
Practice Address - Zip Code:24531-5253
Practice Address - Country:US
Practice Address - Phone:434-432-0216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101014610207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89011P8Medicaid
3980490001OtherADMINISTAR FEDERAL
CJ6245OtherMEDICARE RAILRAOD
C05903Medicare ID - Type Unspecified