# SOUTHERN MAINE GASTROENTEROLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609941509
- **Authorized official:** JOHN THOMPSON DO (PROVIDER)
- **Authorized official phone:** (207) 467-9156

## Contact information

- **Practice address:** 10 STORER ST, UNIT 106, LAFAYETTE CENTER, KENNEBUNK, ME 04043-6875
- **Practice address phone:** (207) 467-9156
- **Practice address fax:** (207) 467-9157
- **Mailing address:** PMB 2700, 4 SCAMMON ST, SUITE 19, SACO, ME 04072
- **Mailing address phone:** (207) 282-4704
- **Mailing address fax:** (207) 286-3218

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |
| 208C00000X | Colon & Rectal Surgery Physician | — | NULL | — |
| 208C00000X | Colon & Rectal Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 11/24/2006
- **Last updated:** 05/23/2008