Organization
LIFELINC ANESTHESIA V, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY L THOMPSON MD (PRESIDENT)
(901) 207-2017
Entity
Organization
Contact information
Practice address
2100 N 7TH ST, WEST MEMPHIS, AR 72301-2017
(901) 844-1590
Mailing address
3340 PLAYERS CLUB PKWY STE 350, MEMPHIS, TN 38125-8949
(901) 844-1590
(844) 752-2163
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232289002
—
AR
Enumeration date
06/29/2018
Last updated
09/29/2020
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