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Individual
DR. BROOK ALLEN THOMSON
Active
Individual
DR. BROOK ALLEN THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-10685
ID
207V00000X
Obstetrics & Gynecology Physician
MD25272
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079178000
BLUE CROSS
OR
05
—
275405
—
OR
01
—
9305053253018
EMPLOYER ID
OR
01
—
P00163218
PACIFIC SOURCE
OR
Enumeration date
07/03/2006
Last updated
06/26/2009
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