Provider Demographics
NPI:1922111319
Name:THOMPSOM, CLAUDE STEVE (ATC)
Entity Type:Individual
Prefix:
First Name:CLAUDE
Middle Name:STEVE
Last Name:THOMPSOM
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-2946
Mailing Address - Country:US
Mailing Address - Phone:662-473-3400
Mailing Address - Fax:662-473-4389
Practice Address - Street 1:50 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WATER VALLEY
Practice Address - State:MS
Practice Address - Zip Code:38965-2946
Practice Address - Country:US
Practice Address - Phone:662-473-4777
Practice Address - Fax:662-473-2233
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAT00152255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer