Individual
THOMPSON SOUTHWELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 WEALTHY ST SE STE 100, GRAND RAPIDS, MI 49506-2969
(616) 267-7333
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301025559
MI
Other
Enumeration date
05/27/2006
Last updated
06/26/2024
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