Individual
MATHEW RAY THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(618) 204-0029
Mailing address
301 FISHER ST, KEESLER AFB, MS 39534-2508
(618) 204-0029
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0020585
OH
Other
Enumeration date
07/27/2022
Last updated
02/11/2025
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