Provider Demographics
NPI:1063407617
Name:THOMPSON, JAMES S (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 260
Mailing Address - Street 2:MOAK ASSOCIATES
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-0260
Mailing Address - Country:US
Mailing Address - Phone:508-898-8650
Mailing Address - Fax:
Practice Address - Street 1:1132 WESTFIELD ST
Practice Address - Street 2:
Practice Address - City:WEST SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01089-3878
Practice Address - Country:US
Practice Address - Phone:800-378-5454
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA732302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00065660OtherRAILROAD MEDICARE
MAJ11086OtherBLUE CARD
MA3077411Medicaid
MAJ11086OtherFEDERAL BC/BS
MA073230OtherTUFTS MEDICARE PREFERRED
MAJ11086OtherBC/BS OF MASSACHUSETTS
MA073230OtherTUFTS
MA1501050OtherEVERCARE
MAJ11086OtherBC/BS OF MASSACHUSETTS
MAA35227Medicare ID - Type Unspecified