Doctor Name: | DR. TIMOTHY LUKE THOMPSON |
NPI Number: | 1578747390 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD.201055 |
Business Practice Address: | 1605 S 28th Ave Hattiesburg, MS - 394023110 |
Business Phone Number: | 6015793310 |
Business Fax Number: | 6012640231 |
Mailing Address: | 415 S 28th Ave, HATTIESBURG |
State: | MS |
Postal Code: | 394017246 |
Phone Number: | 6015795463 |
Fax Number: | 6015795240 |
NPI Enumeration Date: | 12/28/2007 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD.201055 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | LA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |