Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD026356 | TN |
NPI | 1023016631 |
---|---|
Provider Name | Dr. Michael Roger Thompson |
First Address | Oak Ridge, TN 37830-5212 |
Second Address | Oak Ridge, TN 37830-5212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 24/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3719998 | (05) | TN |
G12848 | (02) | TN |