Individual
THOMAS C. THOMPSON
Active
Individual
THOMAS C. THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
—
—
103TC0700X
Clinical Psychologist
Primary
129
NM
103TP0016X
Prescribing (Medical) Psychologist
0003
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
468130YRND
MEDICARE
NM
05
—
61755320
—
NM
Enumeration date
11/29/2006
Last updated
08/28/2018
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