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Individual

DR. CARSON JOSEPH THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 808-6026
(570) 271-6578
Mailing address
1000 E MOUNTAIN DR, WILKES BARRE, PA 18711-0027
(570) 808-6026
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
238733-1
NY
207T00000X
Neurological Surgery Physician
Primary
MD019602E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0008602180004
PA
05
02672833
NY
01
CC9269
RR MEDICARE GROUP
PA
01
GU039843
PA MEDICARE GROUP
PA
01
P00260894
RR MEDICARE PIN
PA
Enumeration date
02/23/2006
Last updated
01/18/2012
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