Provider Demographics
NPI:1730318064
Name:THOMPSON, PAUL WILLIAM (LAC)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:WILLIAM
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75-165 HUALALAI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUNA-KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740
Mailing Address - Country:US
Mailing Address - Phone:808-329-0591
Mailing Address - Fax:808-329-2066
Practice Address - Street 1:75-165 HUALALAI RD
Practice Address - Street 2:
Practice Address - City:KAILUNA-KONA
Practice Address - State:HI
Practice Address - Zip Code:96740
Practice Address - Country:US
Practice Address - Phone:808-329-0591
Practice Address - Fax:808-329-2066
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI307171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist