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Individual

KENNETH ARTHUR THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
5010 CAROLINA FOREST BLVD, MYRTLE BEACH, SC 29579-3579
(843) 903-1010
(843) 903-1015
Mailing address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 234-5139

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
1032
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
2020-02536
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000204502
UNISON
SC
05
010321
SC
01
0165925
GHI
SC
01
408253
WELLCARE
SC
01
5502655
AETNA
SC
05
5905507
NC
05
GP4505
SC
01
P00689014
RR MEDICARE
SC
Enumeration date
08/01/2006
Last updated
06/13/2023
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