Provider Demographics
NPI:1376578286
Name:THOMPSON, JEFFERY SCOTT
Entity type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:SCOTT
Last Name:THOMPSON
Suffix:
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 1:2742 COUNTY ROAD 26
Mailing Address - Street 2:
Mailing Address - City:ROGERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35652-5242
Mailing Address - Country:US
Mailing Address - Phone:256-810-7217
Mailing Address - Fax:
Practice Address - Street 1:1661 LEE ST
Practice Address - Street 2:
Practice Address - City:ROGERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35652-7606
Practice Address - Country:US
Practice Address - Phone:256-247-5451
Practice Address - Fax:256-247-7866
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7910183500000X
AL11677183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist