Individual
DR. TIMOTHY LUKE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1605 S 28TH AVE, HATTIESBURG, MS 39402-3110
(601) 579-3310
(601) 264-0231
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 579-3310
(601) 579-5240
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD.201055
LA
207Y00000X
Otolaryngology Physician
Primary
21438
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03520851
—
MS
Enumeration date
12/28/2007
Last updated
07/20/2020
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