Individual
MR. BRENT W. THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1675 TRINITY DR, PENSACOLA, FL 32504-5708
(850) 416-2280
(850) 416-2259
Mailing address
PO BOX 2699, PENSACOLA, FL 32513-2699
(850) 416-2280
(850) 416-2259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA910343
FL
363AM0700X
Medical Physician Assistant
PA910343
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009937643
—
AL
05
—
02921353
—
MS
05
—
291054300
—
FL
Enumeration date
11/02/2006
Last updated
07/21/2022
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