Individual
MS. JOAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30 N 1900 E, RM 4B320 SOM, SALT LAKE CITY, UT 84132-2405
(801) 851-6390
Mailing address
30 N 1900 E, RM 4B320 SOM, SALT LAKE CITY, UT 84132-2405
(801) 851-6390
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7524958-1206
UT
363AM0700X
Medical Physician Assistant
003841
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01285029
—
NY
Enumeration date
10/26/2006
Last updated
07/11/2012
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