Provider Demographics
NPI:1386739209
Name:THIGPEN, LANCE BUDGE (MD)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:BUDGE
Last Name:THIGPEN
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 1:1 ANNA MARSH LANE
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302
Mailing Address - Country:US
Mailing Address - Phone:802-258-7785
Mailing Address - Fax:802-258-3723
Practice Address - Street 1:1 ANNA MARSH LANE
Practice Address - Street 2:
Practice Address - City:BRATTLEBORO
Practice Address - State:VT
Practice Address - Zip Code:05302
Practice Address - Country:US
Practice Address - Phone:802-258-7785
Practice Address - Fax:802-258-3723
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0540552084P0800X, 2084P0804X
VT042.00125392084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT003195401OtherMEDICARE
NH3086728Medicaid
VT1021583Medicaid
GA797863397AMedicaid