Provider Demographics
NPI:1285270942
Name:THOMPSON, DON RAY JR
Entity type:Individual
Prefix:
First Name:DON
Middle Name:RAY
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3637 GREEN RD STE 3G
Mailing Address - Street 2:
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-5717
Mailing Address - Country:US
Mailing Address - Phone:216-220-8774
Mailing Address - Fax:
Practice Address - Street 1:3281 W 111TH ST APT 1
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44111-3640
Practice Address - Country:US
Practice Address - Phone:216-200-2750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-18
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist