Individual
DR. JONATHAN WILLIAM THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4809 AMBASSADOR CAFFERY PKWY, SUITE 100, LAFAYETTE, LA 70508-8800
(337) 769-8660
(337) 769-8661
Mailing address
4809 AMBASSADOR CAFFERY PKWY, SUITE 100, LAFAYETTE, LA 70508-8800
(337) 769-8660
(337) 769-8661
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD.208208
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD.208208
LOUISIANA MEDICAL LICENSE
LA
05
—
PENDING
—
LA
Enumeration date
05/09/2011
Last updated
08/09/2016
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