MEDICARE: DR. JOHN STEPHEN THOMPSON MD

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	207RR0500X	Rheumatology Physician	30682	CO
2	207RR0500X	Rheumatology Physician	MD185198	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00944833	OTHER	CO	MEDICARE RAILROAD CARRIER PTAN

Other Identifiers

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

General Provider Information

NPI Number	:	1972581502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN STEPHEN THOMPSON MD

Provider Business Mailing Address
First Line	:	444 NW ELKS DR
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97330-3758
Country	:	US
Telephone Number	:	541-754-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	3680 NW SAMARITAN DR
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97330-3737
Country	:	US
Telephone Number	:	541-754-1150
Fax Number	:

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	03/28/2018

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Directions to “ DR. JOHN STEPHEN THOMPSON MD” Practice Location

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