Provider Demographics
NPI:1295734861
Name:W. H. THOMPSON, D.C., P.C.
Entity type:Organization
Organization Name:W. H. THOMPSON, D.C., P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/CORPORATE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HAL
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-653-3242
Mailing Address - Street 1:404 S LEWIS ST
Mailing Address - Street 2:
Mailing Address - City:TABOR CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28463-2316
Mailing Address - Country:US
Mailing Address - Phone:910-653-3242
Mailing Address - Fax:910-653-2304
Practice Address - Street 1:404 S LEWIS ST
Practice Address - Street 2:
Practice Address - City:TABOR CITY
Practice Address - State:NC
Practice Address - Zip Code:28463-2316
Practice Address - Country:US
Practice Address - Phone:910-653-3242
Practice Address - Fax:910-653-2304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1222111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8908846Medicaid
SCCH 1222 / GCH 249Medicaid
NC620569OtherAMER. CHIR. NET. (ACN)
NC08846OtherBLUE CROSS/BLUE SHIELD
NC08846OtherBLUE CROSS/BLUE SHIELD
NC2456144 / 244340AMedicare ID - Type Unspecified