Individual
DR. MICHAEL BARTLETT THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3535 30TH AVE, 203, KENOSHA, WI 53144-1632
(262) 657-6104
(262) 657-6194
Mailing address
3535 30TH AVE, 203, KENOSHA, WI 53144-1632
(262) 657-6104
(262) 657-6194
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
343
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000046034
PTAN
WI
05
—
43208600
—
WI
Enumeration date
05/19/2006
Last updated
08/05/2008
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