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General NPI Number Information
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NPI Number | 1013070952
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Entity Type | Organization
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Legal Business Name | VICKI THOMSON PA
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 7380 FRANCE AVE S
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City | EDINA
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State | MN
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Zip | 55435-4535
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Country | US
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Telephone | 952-927-7337
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Fax | 952-927-8610
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Provider Business Mailing Address
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Address Line | 7025 FRANCE AVE S STE 100
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City | EDINA
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State | MN
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Zip | 55435-4215
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Country | US
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Telephone | 952-927-7337
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Fax | 952-927-8610
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICKI THOMSON
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Credential | MD
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Telephone | 952-927-7337
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 1101
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License Number State | MN
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