Healthcare Provider Details

I. General information

NPI: 1932362191
Provider Name (Legal Business Name): GEORGE G. THOMSON, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2008
Last Update Date: 07/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 MAIN ST
PETERBOROUGH NH
03458-2419
US

IV. Provider business mailing address

69 MAIN ST
PETERBOROUGH NH
03458-2419
US

V. Phone/Fax

Practice location:
  • Phone: 603-924-3644
  • Fax: 603-924-7420
Mailing address:
  • Phone: 603-924-3644
  • Fax: 603-924-7420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberNH8923
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE GRAHAM THOMSON
Title or Position: OWNER
Credential: M.D.
Phone: 603-924-3644