Thompson, Teddy Leonard

Thompson, Teddy Leonard is an individual health care provider with primary practice located at 1526 Rose Street , La Crosse WI 54603. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Thompson, Teddy Leonard can be contacted via phone (608) 317-4644.

Contact Information

Primary practice address
1526 Rose Street La Crosse WI 54603
Fax: (608) 783-5426
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20493 Wisconsin
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X WI20493 Wisconsin

Profile Details

NPI number 1083618722
LBN Legal business name Thompson, Teddy Leonard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Oct 18th, 2018 - about 8 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 1083618722 NPPES
Wisconsin MEDICAID 30561200

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