Provider Demographics
NPI:1366539181
Name:THOMPSON, JON C (MD)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:C
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6850 TPC DR STE 116
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-3145
Mailing Address - Country:US
Mailing Address - Phone:972-838-1635
Mailing Address - Fax:972-838-1634
Practice Address - Street 1:6850 TPC DR STE 116
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-3145
Practice Address - Country:US
Practice Address - Phone:972-838-1635
Practice Address - Fax:972-838-1634
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN4800207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
8DP470OtherBLUE CROSS
TX314189701Medicaid
TX265852YK5BMedicare PIN