Individual
JOHN R THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD2016-0696
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3097535
—
TN
01
—
4051961
BCBS
TN
Enumeration date
06/01/2005
Last updated
10/16/2019
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