Individual
DR. BROOK ALLEN THOMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1055 N. CURTIS RD, BOISE, ID 83706-1309
(208) 367-2121
Mailing address
3340 EAST GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
M-10685
ID
207V00000X
Obstetrics & Gynecology Physician
MD25272
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
079178000
BLUE CROSS
OR
05
—
275405
—
OR
01
—
9305053253018
EMPLOYER ID
OR
01
—
P00163218
PACIFIC SOURCE
OR
Enumeration date
07/03/2006
Last updated
06/26/2009
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