MEDICARE: DR. RICHARD P THOMPSON O.D.

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	152W00000X	Optometrist	596	ME

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080056485	OTHER	ME	RR MEDICARE ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0316060001	OTHER	ME	DMERC

General Provider Information

NPI Number	:	1639165095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD P THOMPSON O.D.

Provider Business Mailing Address
First Line	:	6 WASHINGTON ST
Second Line	:	SUITE C
City	:	SANFORD
State	:	ME
Zip	:	04073-3021
Country	:	US
Telephone Number	:	207-324-4010
Fax Number	:	207-324-4010

Provider Business Practice Location Address
First Line	:	6 WASHINGTON ST
Second Line	:	SUITE C
City	:	SANFORD
State	:	ME
Zip	:	04073-3021
Country	:	US
Telephone Number	:	207-324-4010
Fax Number	:	207-324-4010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	05/06/2008

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Directions to “ DR. RICHARD P THOMPSON O.D.” Practice Location

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