Provider Demographics
NPI:1619954716
Name:THOMPSON, ANDREW A (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9536 SE MARICAMP RD
Mailing Address - Street 2:#108
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34472-2483
Mailing Address - Country:US
Mailing Address - Phone:352-687-4111
Mailing Address - Fax:352-687-4112
Practice Address - Street 1:9536 SE MARICAMP RD
Practice Address - Street 2:#108
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34472-2483
Practice Address - Country:US
Practice Address - Phone:352-687-4111
Practice Address - Fax:352-687-4112
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 4833111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22103Medicare ID - Type Unspecified
T85300Medicare UPIN