Provider Demographics
NPI:1548358989
Name:THOMPSON, BENJAMIN FRANKLIN JR (DC)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:FRANKLIN
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2610 CHOCTAW ST
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36303-2540
Mailing Address - Country:US
Mailing Address - Phone:334-793-2096
Mailing Address - Fax:323-313-1540
Practice Address - Street 1:1001 TATE DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36301-4334
Practice Address - Country:US
Practice Address - Phone:334-793-2096
Practice Address - Fax:334-793-7559
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1251111N00000X
AL1-137625163W00000X
FL9351425163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL4803714OtherCIGNA
AL51002985OtherAL BLUE CROSS BLUE
AL4803714OtherCIGNA
ALT91238Medicare UPIN