Organization
BRADLEY M. THOMPSON, O.D.,P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY M. THOMPSON (PRES.)
(601) 469-3441
Entity
Organization
Contact information
Practice address
143 W THIRD ST, FOREST, MS 39074-4103
(601) 469-3441
(601) 469-3449
Mailing address
143 W THIRD ST, FOREST, MS 39074-4103
(601) 469-3441
(601) 469-3449
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
659
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087620
—
MS
05
—
00880217
—
MS
05
—
05853379
—
MS
Enumeration date
06/21/2007
Last updated
03/12/2008
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