Individual
JOHN DARYL THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
10494 W THUNDERBIRD BLVD, STE 102, SUN CITY, AZ 85351-3058
(623) 537-5600
(866) 939-2673
Mailing address
18444 N 25TH AVE, STE 310, PHOENIX, AZ 85023-1266
(623) 537-5600
(866) 939-2673
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4022
AZ
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
4022
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5550830001
MEDICARE NSC SCW
AZ
01
—
5550830003
MEDICARE NSC PEORIA
AZ
01
—
5550830007
MEDICARE NSC DV
AZ
01
—
5550830010
MEDICARE NSC GILBERT
AZ
05
—
854259
—
AZ
01
—
P00220530
RR MEDICARE
AZ
Enumeration date
06/12/2006
Last updated
04/24/2014
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