Provider Demographics
NPI:1740236694
Name:THOMPSON, JASON BYRON (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:BYRON
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PILOT MEDICAL DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3412
Mailing Address - Country:US
Mailing Address - Phone:205-856-2284
Mailing Address - Fax:205-815-4777
Practice Address - Street 1:100 PILOT MEDICAL DR STE 300
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3412
Practice Address - Country:US
Practice Address - Phone:205-815-4810
Practice Address - Fax:205-815-4864
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL25087174400000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1740236694OtherUHC
AL51522240OtherBCBS
ALP00637078OtherRRMC
AL1740236694Medicaid
AL5780115OtherCIGNA
ALH84145Medicare UPIN
AL1740236694OtherUHC