Individual
MR. JESUP DEANE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
510 BUTLER AVE, MARTINSBURG, WV 25405-9990
(304) 263-0811
Mailing address
19965 LINCOLN RD, PURCELLVILLE, VA 20132-5142
(540) 338-5894
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110001508
VA
Other
Enumeration date
05/07/2007
Last updated
06/17/2011
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