Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2010-00736 | NC |
N | 207X00000X | Orthopaedic Surgeon | N2317 | TX |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | 2010-00736 | NC |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | N2317 | TX |
NPI | 1790906543 |
---|---|
Provider Name | Corey A Thompson |
First Address | Raleigh, NC 27604-0010 |
Second Address | Raleigh, NC 27610-1214 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 13/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
45570U | (02) | NC |