Individual
GRANT COLE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2050 MEADOWVIEW PKWY, KINGSPORT, TN 37660-7475
(423) 230-5000
Mailing address
1256 DERICK PRIVATE DR, BLOUNTVILLE, TN 37617-5851
(423) 341-5398
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
08/07/2021
Last updated
08/07/2021
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