Individual
DR. BRENDA J THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL DOCTOR
Contact information
Practice address
1021 W 5TH AVE, GARY, IN 46402-1703
(219) 880-1190
(219) 880-0784
Mailing address
1021 W 5TH AVE, GARY, IN 46402-1703
(219) 880-1190
(219) 880-0784
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
036047737
IL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
01028053
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100167580A
—
IN
Enumeration date
07/28/2006
Last updated
01/07/2013
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