Provider Demographics
NPI:1447354956
Name:THOMPSON, STEPHEN CRAIG (DO)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:CRAIG
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 158
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26847-0158
Mailing Address - Country:US
Mailing Address - Phone:304-257-2527
Mailing Address - Fax:
Practice Address - Street 1:65 HOSPITAL DR STE 102
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-9549
Practice Address - Country:US
Practice Address - Phone:304-257-2527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1372207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine