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Organization

SOUTHERN MAINE GASTROENTEROLOGY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN THOMPSON DO (PROVIDER)
(207) 467-9156
Entity
Organization

Contact information

Practice address
10 STORER ST, UNIT 106, LAFAYETTE CENTER, KENNEBUNK, ME 04043-6875
(207) 467-9156
(207) 467-9157
Mailing address
PMB 2700, 4 SCAMMON ST, SUITE 19, SACO, ME 04072
(207) 282-4704
(207) 286-3218

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
208C00000X
Colon & Rectal Surgery Physician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1428193
AETNA
05
432448100
ME
01
878196
CIGNA
ME
Enumeration date
11/24/2006
Last updated
05/23/2008
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