MEDICARE: DR. SHAUN PATRICK THOMPSON M.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	207Q00000X	Family Medicine Physician	36467	CO

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	:	1831194950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAUN PATRICK THOMPSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 2153 DEPT 40339
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35287-9387
Country	:	US
Telephone Number	:	706-271-0100
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 FREMONT AVE
Second Line	:
City	:	FORT MORGAN
State	:	CO
Zip	:	80701-3553
Country	:	US
Telephone Number	:	970-867-8261
Fax Number	:	970-867-1931

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

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	12/27/2022

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