Individual
MATTHEW J THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1087 W MASON ST, #1, GREEN BAY, WI 54303-1859
(920) 499-3102
Mailing address
1087 W MASON ST, #1, GREEN BAY, WI 54303-1859
(920) 499-3102
(920) 499-9636
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036117608
IL
207W00000X
Ophthalmology Physician
Primary
53859-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036117608
—
IL
05
—
1659336733
—
WI
01
—
P00404391
RR MEDICARE
IL
Enumeration date
04/20/2006
Last updated
12/20/2021
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