Provider Demographics
NPI:1811324494
Name:THOMPSON & CHOU CENTER FOR PHYSICAL
Entity type:Organization
Organization Name:THOMPSON & CHOU CENTER FOR PHYSICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:V
Authorized Official - Last Name:CHOU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:502-583-4700
Mailing Address - Street 1:PO BOX 43905
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40253-0905
Mailing Address - Country:US
Mailing Address - Phone:502-583-4700
Mailing Address - Fax:502-583-8434
Practice Address - Street 1:1931 WEST ST
Practice Address - Street 2:SUITE B
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-5039
Practice Address - Country:US
Practice Address - Phone:502-583-4700
Practice Address - Fax:502-583-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-27
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01047580174400000X
IN28184126A174400000X
IN01045575174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN091290OtherMEDICARE GROUP
IN200207160AMedicaid
KY65932410Medicaid
KY5622OtherMEDICARE GROUP