Basic Information
| Provider Information | |||||||||
| NPI: | 1477571388 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JEFFREY W. THOMPSON, MD, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1901 W HAMILTON ST | ||||||||
| Address2: | SUITE 100B | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181046459 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109731410 | ||||||||
| FaxNumber: | 6109731449 | ||||||||
| Practice Location | |||||||||
| Address1: | 121 N CEDAR CREST BLVD | ||||||||
| Address2: | SUITE F | ||||||||
| City: | ALLENTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 181044664 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104330246 | ||||||||
| FaxNumber: | 6104330248 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2006 | ||||||||
| LastUpdateDate: | 06/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | BINDER | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING COORDINATOR | ||||||||
| AuthorizedOfficialTelephone: | 6109731410 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD014786E | PA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1566347 | 01 | PA | HIGHMARK BLUE SHIELD | OTHER | DB1085 | 01 | PA | PALMETTO GBA | OTHER | 50032027 | 01 | PA | CAPITAL BLUE CROSS | OTHER |