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Individual

DR. THOMAS HUNTER THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2508 NW MEDICAL PARK DR, ROSEBURG, OR 97470-5510
(541) 677-1256
(541) 673-1160
Mailing address
2508 NW MEDICAL PARK DR, ROSEBURG, OR 97471-5510
(541) 677-1256
(541) 673-1160

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD13952
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200046321
RAILROAD MEDICARE
OR
05
221523
OR
01
74-3064196
TAX ID
OR
01
MD13952
OR STATE MEDICAL LICENSE
OR
Enumeration date
05/08/2006
Last updated
04/30/2009
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