Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 21060 | KY |
N | 207RA0201X | Internist - Allergy & Immunology | 21060 | KY |
NPI | 1528021656 |
---|---|
Provider Name | Dr. John Secord Thompson |
First Address | Lexington, KY 40502-3016 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 05/06/2020 |