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Individual
MARK EDMUND THOMPSON
Active
Individual
MARK EDMUND THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
OS10194
FL
2085R0203X
Therapeutic Radiology Physician
Primary
OS10194
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02484
BLUE CROSS BLUE SHIELD
FL
05
—
0825156
—
OH
05
—
279300800
—
FL
01
—
310302
AVMED
FL
01
—
PTAN AG644E
LINKED TO GROUP PTAN IE881A EFFECTIVE 08/01/2015
FL
Enumeration date
08/19/2005
Last updated
05/05/2025
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