Provider Demographics
NPI:1568923134
Name:THOMPSON SURGICAL PLLC
Entity Type:Organization
Organization Name:THOMPSON SURGICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:404-396-9039
Mailing Address - Street 1:77 ALPINE WAY
Mailing Address - Street 2:
Mailing Address - City:SOUTH HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11746-4610
Mailing Address - Country:US
Mailing Address - Phone:404-396-9039
Mailing Address - Fax:
Practice Address - Street 1:77 ALPINE WAY
Practice Address - Street 2:
Practice Address - City:SOUTH HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11746-4610
Practice Address - Country:US
Practice Address - Phone:404-396-9039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-27
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty