Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 00002939 | AL |
N | 207QA0401X | Family Doctor - Addiction Medicine | 00002939 | AL |
NPI | 1801954821 |
---|---|
Provider Name | Edward Hubbard Thompson |
First Address | Gadsden, AL 35901-5452 |
Second Address | Gadsden, AL 35901-5567 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 06/06/2013 |