Provider Demographics
NPI:1609995828
Name:DR. ANDY THOMPSON
Entity Type:Organization
Organization Name:DR. ANDY THOMPSON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:ANDERSON
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:931-526-3381
Mailing Address - Street 1:22 N JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-3334
Mailing Address - Country:US
Mailing Address - Phone:931-526-3381
Mailing Address - Fax:931-520-4804
Practice Address - Street 1:22 N JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-3334
Practice Address - Country:US
Practice Address - Phone:931-526-3381
Practice Address - Fax:931-520-4804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty