Individual
DR. BRADLEY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
7464 TCHULAHOMA RD, SOUTHAVEN, MS 38671-9249
(662) 349-4494
(662) 349-4495
Mailing address
PO BOX 225, SOUTHAVEN, MS 38671-0003
(662) 349-4494
(662) 349-4495
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
807
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1C350044428
RAILROAD MEDICARE
MS
01
—
3045182
BLUE CROSS BLUE SHIELD
TN
Enumeration date
01/24/2008
Last updated
01/24/2008
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