Organization
BARRY L THOMPSON
Active
Other names
Central Dermatology LLC
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY L THOMPSON M.D. (SOLE MEMBER)
(706) 738-4442
Entity
Organization
Contact information
Practice address
2060 CENTRAL AVE, AUGUSTA, GA 30904-4177
(706) 738-4442
(706) 738-3841
Mailing address
2060 CENTRAL AVE, AUGUSTA, GA 30904-4177
(706) 738-4442
(706) 738-3841
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GP29679
RAILROAD MEDICARE
GA
05
—
GPA783
—
SC
Enumeration date
09/26/2005
Last updated
07/19/2007
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