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Individual

KEITH THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
143 KENNEDY DR, SUITE A, MARTIN, TN 38237-3309
(731) 587-5321
(731) 587-2145
Mailing address
143 KENNEDY DR, SUITE A, MARTIN, TN 38237-3309
(731) 587-5321
(731) 587-2145

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
18049
MS
208600000X
Surgery Physician
Primary
29386
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000188621
UNISON
TN
05
07375201
MS
01
36655
TLC
TN
05
3815542
TN
01
4128847
BCBS
TN
01
4383459
AETNA
TN
Enumeration date
03/24/2006
Last updated
10/09/2008
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