Individual
RYAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1055 N CURTIS RD, BOISE, ID 83706-1309
(208) 367-6416
Mailing address
PO BOX 7411114, CHICAGO, IL 60674-1114
(208) 367-5170
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
O-1837
ID
207R00000X
Internal Medicine Physician
MRO-1806
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2019
Last updated
09/29/2023
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