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Contact Information

GLEN THOMPSON III, CSA
138 RAVEN DR
BEREA, KY40403
 Phone: 859-200-3356
 Fax: 502-451-9291
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type
Indicates primary specialty

NPI Profile & details for GLEN THOMPSON III · (Male)

NPI Number 1629299268
Status Active
Credentials CSA
Entity Individual
Enumeration date 05/01/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • KY License # 2222
  • KY Other 000000493588 ANTHEM
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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