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NPI Code Detail

MEDICARE: ADAM THOMPSON PA-C

MEDICARE: ADAM THOMPSON PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant1807NE

General Provider Information

NPI Number : 1538584321
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM THOMPSON PA-C
Provider Business Mailing Address
First Line : 19421 V ST
Second Line :
City : OMAHA
State : NE
Zip : 68135-4250
Country : US
Telephone Number : 402-305-4864
Fax Number :
Provider Business Practice Location Address
First Line : 2207 OSBORNE DR W
Second Line : SUITE 100
City : HASTINGS
State : NE
Zip : 68901-9112
Country : US
Telephone Number : 402-462-2139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2014
Last Update Date : 03/03/2014

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Directions to “ ADAM THOMPSON PA-C” Practice Location

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