Individual
MR. GARY C THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
109 BRIDGE ST STE 300, DANVILLE, VA 24541-1222
(434) 793-4711
(434) 797-2514
Mailing address
1772 BLAIR LOOP RD, DANVILLE, VA 24541-5013
(434) 822-0339
(434) 797-2514
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110000067
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008954542
—
VA
01
—
970003213
RR MEDICARE PIN
VA
Enumeration date
06/07/2006
Last updated
02/05/2018
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