Provider Demographics
NPI:1295924520
Name:JOSEPH L THOMPSON PSC
Entity type:Organization
Organization Name:JOSEPH L THOMPSON PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LYNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-895-5471
Mailing Address - Street 1:4010 DUPONT CIR STE 511
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4888
Mailing Address - Country:US
Mailing Address - Phone:502-895-5471
Mailing Address - Fax:502-895-5520
Practice Address - Street 1:4010 DUPONT CIR STE 511
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4888
Practice Address - Country:US
Practice Address - Phone:502-895-5471
Practice Address - Fax:502-895-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14848207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY207N00000XOtherTAXONOMY
KY0709702Medicare PIN
KY0709701Medicare PIN
KYC71186Medicare UPIN
KY207N00000XOtherTAXONOMY
KY7097Medicare PIN