Individual
DR. WILLARD CHANDLER THOMPSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
721 GROVE ST, SALISBURY, NC 28144-3339
(704) 633-2732
Mailing address
721 GROVE ST, SALISBURY, NC 28144-3339
(704) 633-2732
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
30103
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30103
STATE LICENSE NUMBER
NC
01
—
83199
BLUE CROSS BLUE SHIELD
NC
05
—
8983199
—
NC
Enumeration date
09/26/2005
Last updated
10/17/2008
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