Provider Demographics
NPI:1518764042
Name:THOMPSON, MICHIL J
Entity type:Individual
Prefix:MISS
First Name:MICHIL
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5603 DEFOREST DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-7515
Mailing Address - Country:US
Mailing Address - Phone:740-213-5520
Mailing Address - Fax:
Practice Address - Street 1:5603 DEFOREST DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-7515
Practice Address - Country:US
Practice Address - Phone:740-213-5520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3747P101XMedicaid