Provider Demographics
NPI:1871776351
Name:ISAAC K. A. THOMPSON MD PA
Entity type:Organization
Organization Name:ISAAC K. A. THOMPSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561-499-9292
Mailing Address - Street 1:6200 W ATLANTIC AVE
Mailing Address - Street 2:#100
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33484-3506
Mailing Address - Country:US
Mailing Address - Phone:561-499-9292
Mailing Address - Fax:561-499-1318
Practice Address - Street 1:6200 W ATLANTIC AVE
Practice Address - Street 2:#100
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33484-3506
Practice Address - Country:US
Practice Address - Phone:561-499-9292
Practice Address - Fax:561-499-1318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-07
Last Update Date:2013-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0063531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK0971Medicare PIN