Provider Demographics
NPI:1689778219
Name:THOMPSON, WILLIAM DANIEL (DC)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:DANIEL
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 1:4922 BRAINERD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37411-3901
Mailing Address - Country:US
Mailing Address - Phone:423-893-6691
Mailing Address - Fax:423-899-8193
Practice Address - Street 1:4922 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-3901
Practice Address - Country:US
Practice Address - Phone:423-893-6691
Practice Address - Fax:423-899-8193
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN742111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0123905OtherBCBS
TNU27319Medicare UPIN
TN3676154Medicare PIN