Individual
FRED MARIL THOMPSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
100 WHETSTONE PL, STE 310, ST AUGUSTINE, FL 32086-5774
(904) 217-7450
Mailing address
PO BOX 3123, ST AUGUSTINE, FL 32085-3123
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP9246631
FL
Other
Enumeration date
04/06/2015
Last updated
04/06/2015
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