Provider Demographics
NPI:1912263625
Name:THOMPSON, VERONITA C (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONITA
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:VERONITA
Other - Middle Name:CAROLINE
Other - Last Name:CRAWFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:404-752-1088
Practice Address - Street 1:3640 TRAMORE POINTE PARKWAY, SW
Practice Address - Street 2:KAISER PERMANENTE WEST COBB MEDICAL CENTER
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106
Practice Address - Country:US
Practice Address - Phone:770-439-4700
Practice Address - Fax:404-752-1088
Is Sole Proprietor?:No
Enumeration Date:2012-04-06
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA075750207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program