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Individual

DR. JOHNATHAN H THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1321
(863) 284-1786
Mailing address
1324 LAKELAND HILLS BLVD, LAKELAND, FL 33805-4543
(863) 687-1100
(904) 450-6401

Taxonomy

Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
78645
GA
207XX0801X
Orthopaedic Trauma Physician
Primary
OS15270
FL
207XX0801X
Orthopaedic Trauma Physician
OT015575
PA
208D00000X
General Practice Physician
UO2822
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
024956000
FL
Enumeration date
08/24/2011
Last updated
10/19/2022
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