Individual
DR. KEITH P THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5582 MEMORIAL DR STE 200, STONE MOUNTAIN, GA 30083-3215
(404) 513-9965
Mailing address
4338 TOWN COMMONS CIR NE, ATLANTA, GA 30319-1160
(404) 513-9965
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
031339
GA
207W00000X
Ophthalmology Physician
Primary
031339
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10636649
CAQH
GA
Enumeration date
08/03/2006
Last updated
07/21/2022
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