Provider Demographics
NPI:1659551851
Name:THOMPSON, STEVEN P (PA-C)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:P
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 AIRPORT BLVD STE D430
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-6759
Mailing Address - Country:US
Mailing Address - Phone:512-639-1660
Mailing Address - Fax:512-639-9122
Practice Address - Street 1:6701 AIRPORT BLVD STE D430
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-639-1660
Practice Address - Fax:251-639-9122
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2018-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPA.564363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL132137Medicaid
AL102I977883Medicare PIN