| Traci Thompson Md, Pa | |
|
904 E Henry Ave Tampa FL 33604-7143 | |
| (813) 501-7796 | |
| Not Available |
| Full Name | Traci Thompson Md, Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 904 E Henry Ave, Tampa, Florida |
| Authorized Official Name and Position | Traci Thompson (CEO) |
| Authorized Official Contact | 4104933901 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traci Thompson Md, Pa 14714 Tudor Chase Dr Tampa FL 33626-3339 Ph: (410) 493-3901 | Traci Thompson Md, Pa 904 E Henry Ave Tampa FL 33604-7143 Ph: (813) 501-7796 |
| NPI Number | 1043984875 |
|---|---|
| Provider Enumeration Date | 08/04/2021 |
| Last Update Date | 08/09/2021 |
| Medicare PECOS PAC ID | 6204232226 |
|---|---|
| Medicare Enrollment ID | O20210831000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043984875 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Traci Lynn Thompson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740351782 PECOS PAC ID: 8123017159 Enrollment ID: I20041112000864 |
| Provider Name | Morgan Butts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679234488 PECOS PAC ID: 5496132128 Enrollment ID: I20220518000376 |
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