Provider Demographics
NPI:1801866595
Name:THOMPSON, PAUL E (NP)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 WEST 27TH STREET
Mailing Address - Street 2:
Mailing Address - City:ASHTABULA
Mailing Address - State:OH
Mailing Address - Zip Code:44004
Mailing Address - Country:US
Mailing Address - Phone:440-997-5427
Mailing Address - Fax:440-997-5486
Practice Address - Street 1:416 WEST 27TH STREET
Practice Address - Street 2:
Practice Address - City:ASHTABULA
Practice Address - State:OH
Practice Address - Zip Code:44004
Practice Address - Country:US
Practice Address - Phone:440-997-5427
Practice Address - Fax:440-997-5486
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP03697363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHS96141Medicare UPIN