Individual
THERON WAYNE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 238-8073
(706) 238-8081
Mailing address
1825 MARTHA BERRY BLVD NW, ROME, GA 30165-1625
(706) 238-8073
(706) 238-8081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
051772
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000957052D
—
GA
Enumeration date
02/24/2006
Last updated
07/29/2008
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