Individual
PATRICK D THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4130 DUTCHMANS LN, SUITE 300, LOUISVILLE, KY 40207-4713
(502) 897-1794
(502) 897-0093
Mailing address
4130 DUTCHMANS LN, SUITE 300, LOUISVILLE, KY 40207-4713
(502) 897-1794
(502) 897-0093
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003115
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000710956
ANTHEM
KY
01
—
201022440
MEDICAID INDIANA
KY
01
—
50033295
PASSPORT ADVANTAGE
KY
01
—
5637659
AETNA
KY
05
—
7100161720
—
KY
Enumeration date
08/30/2006
Last updated
11/03/2011
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