Individual
DERIK THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
2085 LYNNHAVEN PKWY STE 106-308, VIRGINIA BEACH, VA 23456-1497
(757) 573-3479
Mailing address
2085 LYNNHAVEN PKWY STE 106-308, VIRGINIA BEACH, VA 23456-1497
(757) 573-3479
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0136000166
VA
Other
Enumeration date
07/09/2009
Last updated
12/19/2019
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