Individual
LAURA H THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2055 E SOUTH BLVD STE 505, MONTGOMERY, AL 36116-2004
(334) 747-5000
(334) 747-5012
Mailing address
301 BROWN SPRINGS RD, MONTGOMERY, AL 36117-7005
(334) 747-4159
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.88
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102I976053
MEDICARE
AL
05
—
204336
—
AL
01
—
511-93124
BCBS OF ALABAMA
AL
01
—
P01863465
RR MEDICARE
AL
01
—
P12271
VIVA HEALTH
AL
Enumeration date
06/05/2008
Last updated
01/06/2023
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