Individual
EARL R THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3308 SAMSON WAY, BELLEVUE, NE 68123-3234
(402) 291-3373
Mailing address
PO BOX 642117, OMAHA, NE 68164-8117
(402) 398-6254
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1084/001528
IA
363A00000X
Physician Assistant
Primary
1084/001528
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38601
WELLMARK BCBS
IA
01
—
90803
WELLMARK BCBS
NE
Enumeration date
07/07/2005
Last updated
05/13/2015
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