Doctor Name: | PEYTON THOMPSON |
NPI Number: | 1861439069 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | D9687 |
Business Practice Address: | 725 W Cameron Ave Rockdale, TX - 76567 |
Business Phone Number: | 5127600666 |
Business Fax Number: | 8008588698 |
Mailing Address: | 11313 Thompson Rd, WILLIS |
State: | TX |
Postal Code: | 773187573 |
Phone Number: | 5127600666 |
Fax Number: | 8008588698 |
NPI Enumeration Date: | 05/31/2006 |
NPI Last Update Date: | 05/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | D9687 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |