Individual
JEFFREY L. THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3456 E 17TH ST, SUITE 125, AMMON, ID 83406-6757
(208) 529-2828
(208) 529-3890
Mailing address
3456 E 17TH ST, SUITE 125, AMMON, ID 83406-6757
(208) 529-2828
(208) 529-3890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA585
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
805638700
—
ID
Enumeration date
08/31/2006
Last updated
10/03/2012
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