Individual
KEVIN H THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
610 HAWTHORNE AVE SE STE 110, SALEM, OR 97301
(503) 814-4440
(503) 814-4444
Mailing address
PO BOX 886, SALEM, OR 97308-0886
(503) 561-7160
(503) 561-7180
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
DO151094
OR
207RI0011X
Interventional Cardiology Physician
Primary
DO151094
OR
207UN0901X
Nuclear Cardiology Physician
DO151094
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500622719
—
OR
01
—
P00890306
RAILROAD MEDICARE
OR
Enumeration date
12/27/2006
Last updated
07/11/2018
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