Provider Demographics
NPI:1952608150
Name:THOMPSON, JEFFREY ALAN (DPT)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALAN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 GRAVIER ST
Mailing Address - Street 2:7TH FLOOR
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2262
Mailing Address - Country:US
Mailing Address - Phone:504-568-4042
Mailing Address - Fax:504-568-6552
Practice Address - Street 1:1900 GRAVIER ST
Practice Address - Street 2:7TH FLOOR
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2262
Practice Address - Country:US
Practice Address - Phone:504-568-4042
Practice Address - Fax:504-568-6552
Is Sole Proprietor?:No
Enumeration Date:2011-02-24
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA039052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic