Provider Demographics
NPI:1396341467
Name:PAINE, JOSEPH HAMILTON THOMPSON II
Entity type:Individual
Prefix:
First Name:JOSEPH HAMILTON
Middle Name:THOMPSON
Last Name:PAINE
Suffix:II
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 1:3636 16TH ST NW APT B1144
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-4106
Mailing Address - Country:US
Mailing Address - Phone:202-387-8232
Mailing Address - Fax:
Practice Address - Street 1:3636 16TH ST NW APT B1144
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-4106
Practice Address - Country:US
Practice Address - Phone:202-387-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-04
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care