Individual
DR. RUSSELL E THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4116 AVENIDA COCHISE, STE A, SIERRA VISTA, AZ 85635-5824
(520) 452-1125
(520) 452-8674
Mailing address
2445 E WILCOX DR, SIERRA VISTA, AZ 85635-2842
(520) 458-8131
(520) 458-0422
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
821
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
349432002
—
AZ
Enumeration date
08/16/2005
Last updated
07/09/2010
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