Provider Demographics
NPI:1043718273
Name:THOMPSON, GEORGE NOLAN
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:NOLAN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7210 WILLOW HILL DR
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-2671
Mailing Address - Country:US
Mailing Address - Phone:202-594-5191
Mailing Address - Fax:
Practice Address - Street 1:7210 WILLOW HILL DR
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-2671
Practice Address - Country:US
Practice Address - Phone:202-594-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-23
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant