Provider Demographics
NPI:1962400507
Name:THOMPSON, JOSEPH C (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:608 TERRY PKWY
Mailing Address - Street 2:
Mailing Address - City:TERRYTOWN
Mailing Address - State:LA
Mailing Address - Zip Code:70056-4306
Mailing Address - Country:US
Mailing Address - Phone:504-361-3937
Mailing Address - Fax:504-364-5700
Practice Address - Street 1:608 TERRY PKWY
Practice Address - Street 2:
Practice Address - City:TERRYTOWN
Practice Address - State:LA
Practice Address - Zip Code:70056-4306
Practice Address - Country:US
Practice Address - Phone:504-361-3937
Practice Address - Fax:504-364-5700
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA11192R207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1661694Medicaid
LA1661694Medicaid
F59332Medicare UPIN