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Individual

NOBLE L THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(610) 429-0693
Mailing address
255 W LANCASTER AVE, PAOLI, PA 19301-1763
(610) 429-0693

Taxonomy

Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD011170E
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD01117E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009231490003
PA
01
0057273000
KEYSTONE HEALTHPLAN EAST
PA
01
0092314902
AMERICHOICE
PA
01
068311
BLUE SHIELD PA
PA
01
2830227
AETNA
PA
Enumeration date
10/26/2006
Last updated
10/04/2007
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