Individual
KATIE M FOX THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2940 E BANNER GATEWAY DR STE 200-250, GILBERT, AZ 85234-2168
(602) 648-5444
(602) 772-3801
Mailing address
PO BOX 80217, PHOENIX, AZ 85060-0217
(602) 385-2115
(480) 418-3323
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3353
AZ
363A00000X
Physician Assistant
PA9106053
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106823400
—
FL
01
—
FV664X
MEDICARE
FL
01
—
Y0AW1
BCBSFL
FL
Enumeration date
03/14/2006
Last updated
11/17/2021
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