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Individual

DR. ROBERT FULTON THOMPSON JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
830 SOUTH GLOSTER STREET, TUPELO, MS 38801
(662) 377-4394
(662) 377-7045
Mailing address
PO BOX 3294, TUPELO, MS 38803
(662) 377-4394
(662) 377-7045

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
11790
MS
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
11790
MS
207R00000X
Internal Medicine Physician
11790
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00112860
MS
Enumeration date
07/12/2006
Last updated
02/06/2013
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