Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 207208 | NY |
N | 207X00000X | Orthopaedic Surgeon | 207208 | NY |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 207208 | NY |
NPI | 1992899868 |
---|---|
Provider Name | William Otto Thompson |
First Address | Poughkeepsie, NY 12603-6442 |
Second Address | Poughkeepsie, NY 12603-6442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 25/01/2019 |