Provider Demographics
NPI:1902417785
Name:THOMPSON, RODNEY DEAN SR
Entity Type:Individual
Prefix:MR
First Name:RODNEY
Middle Name:DEAN
Last Name:THOMPSON
Suffix:SR
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:PO BOX 1415
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-8415
Mailing Address - Country:US
Mailing Address - Phone:234-320-1665
Mailing Address - Fax:
Practice Address - Street 1:1260 SOUTHEAST BLVD APT 35
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-3883
Practice Address - Country:US
Practice Address - Phone:234-320-1665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide