Provider Demographics
NPI:1629730346
Name:THOMPSON, ALEXANDER DAVID
Entity Type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:DAVID
Last Name:THOMPSON
Suffix:
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 1:768 W RODNEY DR
Mailing Address - Street 2:
Mailing Address - City:CAPE GIRARDEAU
Mailing Address - State:MO
Mailing Address - Zip Code:63701-4223
Mailing Address - Country:US
Mailing Address - Phone:573-270-4213
Mailing Address - Fax:
Practice Address - Street 1:768 W RODNEY DR
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-4223
Practice Address - Country:US
Practice Address - Phone:573-270-4213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer