Individual
DR. SAMUEL T THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 859-7222
(317) 859-7220
Mailing address
679 E COUNTY LINE RD, GREENWOOD, IN 46143-1049
(317) 807-1262
(317) 859-4268
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01041048A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000091692
ANTHEM PIN NUMBER
IN
01
—
100194370
MEDICAID GROUP NUMBER
IN
05
—
100343300
—
IN
01
—
1487680518
GROUP NPI
IN
01
—
200288740
MEDICAID GROUP NUMBER
IN
01
—
340012497
MEDICARE RAILROAD
IN
01
—
340012510
MEDICARE RAILROAD
IN
01
—
340012524
MEDICARE RAILROAD
IN
Enumeration date
07/31/2006
Last updated
09/16/2014
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