Provider Demographics
NPI:1598705832
Name:THOMPSEN, JEFFREY P (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:P
Last Name:THOMPSEN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:15 PALOMBA DR
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ENFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06082-3888
Mailing Address - Country:US
Mailing Address - Phone:860-253-9950
Mailing Address - Fax:860-253-9398
Practice Address - Street 1:15 PALOMBA DR
Practice Address - Street 2:SUITE 4
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-3888
Practice Address - Country:US
Practice Address - Phone:860-253-9950
Practice Address - Fax:860-253-9398
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2010-02-08
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Provider Licenses
StateLicense IDTaxonomies
CT041802207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT041802OtherLICENCE