Thompson, Brenda J

Thompson, Brenda J is an individual health care provider with primary practice located at 1021 W 5Th Ave , Gary IN 46402-1703. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Adolescent Medicine is her primary health care specialty. Thompson, Brenda J can be contacted via phone (219) 880-1190.

Contact Information

Primary practice address
1021 W 5Th Ave Gary IN 46402-1703
Phone: (219) 880-1190
Fax: (219) 880-0784
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036047737 Illinois
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 01028053 Indiana

Profile Details

NPI number 1386658250
LBN Legal business name Thompson, Brenda J
Credentials MEDICAL DOCTOR
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Jan 7th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386658250 NPPES
Indiana MEDICAID 100167580A

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