Provider Demographics
NPI:1134571490
Name:THOMPSON, JOSEPH HEATH (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:HEATH
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38302-0400
Mailing Address - Country:US
Mailing Address - Phone:731-425-5752
Mailing Address - Fax:731-422-5743
Practice Address - Street 1:4039 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:MILAN
Practice Address - State:TN
Practice Address - Zip Code:38358-3483
Practice Address - Country:US
Practice Address - Phone:731-686-8995
Practice Address - Fax:731-686-8997
Is Sole Proprietor?:No
Enumeration Date:2016-07-11
Last Update Date:2019-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN3049363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant