Provider Demographics
NPI:1578215802
Name:THOMPSON, HIRY III
Entity Type:Individual
Prefix:MR
First Name:HIRY
Middle Name:
Last Name:THOMPSON
Suffix:III
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 1:623 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053-2115
Mailing Address - Country:US
Mailing Address - Phone:504-533-9885
Mailing Address - Fax:504-336-3180
Practice Address - Street 1:623 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-7005
Practice Address - Country:US
Practice Address - Phone:504-533-9885
Practice Address - Fax:504-336-3180
Is Sole Proprietor?:No
Enumeration Date:2022-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator