Provider Demographics
NPI:1366430472
Name:THOMPSON, MELISSA LANE (MD)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:LANE
Last Name:THOMPSON
Suffix:
Gender:F
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 2295
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28802-2295
Mailing Address - Country:US
Mailing Address - Phone:828-398-5244
Mailing Address - Fax:828-360-3080
Practice Address - Street 1:68-1602 LAIE ST
Practice Address - Street 2:
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738
Practice Address - Country:US
Practice Address - Phone:281-744-2374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0312207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF82376Medicare UPIN
HIGM712ZMedicare PIN