Individual
PETER THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19883
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044797
—
OR
05
—
210965
—
AZ
01
—
838334015
BCBS-ROSEBURG
OR
01
—
8584463012
BCBS-MEDFORD
OR
01
—
858464010
BCBS-SPRINGFIELD
OR
01
—
P00061232
RR MEDICARE
OR
01
—
R134117
MEDICARE-TYPE UNSPECIFIED
OR
Enumeration date
03/31/2006
Last updated
05/12/2008
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