Individual
JORDAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
835 COGBURN AVENUE, SUITE 100, MARIETTA, GA 30060-1008
(770) 422-5557
(770) 422-5456
Mailing address
835 COGBURN AVENUE, SUITE 250, MARIETTA, GA 30060-1010
(770) 422-8815
(770) 422-8816
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
286447
MA
207N00000X
Dermatology Physician
Primary
96159
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2017
Last updated
01/30/2024
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