Basic Information
| Provider Information | |||||||||
| NPI: | 1083093652 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMPSON | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | SCOTT | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2895 | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350562895 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567355072 | ||||||||
| FaxNumber: | 2567355076 | ||||||||
| Practice Location | |||||||||
| Address1: | 1930 AL HIGHWAY 157 STE 317 | ||||||||
| Address2: | |||||||||
| City: | CULLMAN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 350580609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2567347850 | ||||||||
| FaxNumber: | 2567349633 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2015 | ||||||||
| LastUpdateDate: | 01/05/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 208600000X | MD.36556 | AL | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.