Individual
DR. PHIL THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
342 MAGNOLIA DRIVE, RALEIGH, MS 39153
(601) 782-9801
(601) 782-9955
Mailing address
PO BOX 10, RALEIGH, MS 39153-0010
(601) 782-9801
(601) 782-9955
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10521
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00014663
—
MS
01
—
640699015
BLUE CROSS BLUE SHIELD
MS
Enumeration date
12/12/2006
Last updated
06/13/2008
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