Provider Demographics
NPI:1598781494
Name:THOMPSON, ISAAC K (MD)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7107
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33482
Mailing Address - Country:US
Mailing Address - Phone:561-499-9292
Mailing Address - Fax:561-499-1318
Practice Address - Street 1:6200 W ATLANTIC AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484
Practice Address - Country:US
Practice Address - Phone:561-499-9292
Practice Address - Fax:561-499-1318
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME063531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL372661400Medicaid
FL372661400Medicaid
FL18635Medicare ID - Type Unspecified
FL372661400Medicaid