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Mark Edmund Thompson, DO
Therapeutic Radiology Physician in Lake City, Florida
NPI 1487646030

Mark Edmund Thompson is a Therapeutic Radiology Physician based in Lake City, FL and is specialized in Therapeutic Radiology. Mark Edmund Thompson practices in Lake City, FL and has the professional credentials of DO. The NPI Number for Mark Edmund Thompson is 1487646030 and holds a License No. OS10194 (Florida).

The current practice location address for Mark Edmund Thompson is 4520 W Us Highway 90, Lake City, FL and can be reached out via phone at 352-755-0601 and via fax at 352-755-0602.

Location: 4520 W Us Highway 90, Lake City, FL, 32055-8341
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487646030
Provider Name
Mark Edmund Thompson
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
4520 W Us Highway 90, Lake City, FL, 32055-8341
Phone Number
352-755-0601
Fax Number
352-755-0602
Provider Enumeration Date
08/19/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
310302 01 FL AVMED
279300800 05 FL
0825156 05 OH
PTAN AG644E 01 FL LINKED TO GROUP PTAN IE881A EFFECTIVE 08/01/2015
02484 01 FL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
4520 W Us Highway 90
City
Lake City
State
Florida
Zip
32055-8341
Phone Number
352-755-0601
Fax Number
352-755-0602
person
Provider Business Mailing Address Details
Address
4520 W Us Highway 90
City
Lake City
State
Florida
Zip
32055-8341
Phone Number
352-755-0601
Fax Number
352-755-0602
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Radiation Oncology
Taxonomy
2085R0001X
License No.
OS10194 (Florida)
Definition
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Therapeutic Radiology
Taxonomy
2085R0203X
License No.
OS10194 (Florida)
Definition
Definition to come...
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