Individual
THEODORE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1220 VOLUNTEER PKWY, BRISTOL, TN 37620-4628
(423) 274-6610
(423) 274-6619
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
38948
TN
207R00000X
Internal Medicine Physician
0101055839
VA
207R00000X
Internal Medicine Physician
Primary
MD38948
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3327207
—
TN
Enumeration date
06/10/2005
Last updated
06/04/2014
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