Provider Demographics
NPI:1194902288
Name:THOMPSON, PETER W (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:W
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3286 NORTHSIDE PKWY NW STE 1000
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2294
Mailing Address - Country:US
Mailing Address - Phone:404-841-8450
Mailing Address - Fax:404-841-8453
Practice Address - Street 1:3286 NORTHSIDE PKWY NW STE 1000
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-2294
Practice Address - Country:US
Practice Address - Phone:404-841-8450
Practice Address - Fax:404-841-8453
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-30
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA64080208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery