Individual
GARY THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 N MADISON AVE, GREENWOOD, IN 46142-4135
(317) 888-3508
(317) 888-5968
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01042057
IN
207Q00000X
Family Medicine Physician
Primary
01042057A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100333830
—
IN
Enumeration date
08/12/2006
Last updated
03/12/2021
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