Individual
DR. GREGORY JOHN THOMSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
555 E BROADWAY AVE, JACKSON, WY 83001-8640
(833) 437-4863
(949) 561-4107
Mailing address
220 W PEARL ST UNIT 4313, JACKSON, WY 83001-5473
(503) 913-5548
(949) 561-4107
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
12812A
WY
207XX0801X
Orthopaedic Trauma Physician
MEDS7811
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1114511
—
WA
01
—
158337
WASH L & I
WA
05
—
262452
—
OR
Enumeration date
11/21/2006
Last updated
12/19/2020
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