Individual
JEFF P THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036115304
IL
207L00000X
Anesthesiology Physician
115304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R03238
MEDICARE PTAN
IL
Enumeration date
07/13/2007
Last updated
10/10/2008
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