Provider Demographics
NPI:1457604092
Name:THOMPSON, SAMANTHA K (PA)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0158
Mailing Address - Country:US
Mailing Address - Phone:828-837-8131
Mailing Address - Fax:828-837-7687
Practice Address - Street 1:4048 E US 64 ALT
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906-6968
Practice Address - Country:US
Practice Address - Phone:828-837-8131
Practice Address - Fax:828-837-7687
Is Sole Proprietor?:No
Enumeration Date:2012-10-19
Last Update Date:2012-10-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1106799363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant