MEDICARE: JUNITH M. THOMPSON, M.D., S.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
1	207V00000X	Obstetrics & Gynecology Physician	29980-020	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1558661991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNITH M. THOMPSON, M.D., S.C.

Provider Business Mailing Address
First Line	:	6530 SHERIDAN ROAD
Second Line	:	SUITE 9
City	:	KENOSHA
State	:	WI
Zip	:	53143-5063
Country	:	US
Telephone Number	:	262-657-8360
Fax Number	:	262-657-8389

Provider Business Practice Location Address
First Line	:	6530 SHERIDAN ROAD
Second Line	:	SUITE 9
City	:	KENOSHA
State	:	WI
Zip	:	53143-5063
Country	:	US
Telephone Number	:	262-657-8360
Fax Number	:	262-657-8389

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	JUNITH M. THOMPSON
Credential	:	M.D.
Telephone Number	:	262-657-8360

Provider Enumeration Date	:	11/02/2010
Last Update Date	:	03/07/2023

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