Individual
AUSTIN L THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 978-9700
(813) 558-6187
Mailing address
5901 E FOWLER AVE STE 100, TEMPLE TERRACE, FL 33617-2305
(813) 978-9700
(813) 558-6187
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA9102744
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9102744
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292620200
—
FL
01
—
P00640457
RAILROAD MEDICARE
FL
01
—
U8586Z
MEDICARE PTAN
FL
01
—
Y00JA
BCBS
FL
Enumeration date
02/21/2006
Last updated
03/26/2025
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