Provider Demographics
NPI:1306928445
Name:THOMPSON, JAMES L JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:THOMPSON
Suffix:JR
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 468
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-0468
Mailing Address - Country:US
Mailing Address - Phone:207-474-6265
Mailing Address - Fax:207-474-8365
Practice Address - Street 1:46 FAIRVIEW AVE STE 114
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1481
Practice Address - Country:US
Practice Address - Phone:207-474-6943
Practice Address - Fax:207-474-6946
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0367962084N0400X
MEMD262912084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1306928445Medicaid
CT260003877Medicare ID - Type Unspecified
CT001367962Medicaid