Individual
BARRY LANE THOMPSON
Active
Individual
BARRY LANE THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
013094
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000130666B
—
GA
01
—
033800
BLUE CROSS/BLUE SHIELD GA
GA
01
—
265295
FIRST HEALTH PLAN
GA
01
—
406072004
RAILROAD MEDICARE
GA
01
—
4114157
AETNA
GA
05
—
G13094
—
SC
Enumeration date
09/27/2005
Last updated
07/25/2013
Update your record
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