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General NPI Number Information
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NPI Number | 1144296245
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Entity Type | Individual
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Provider Name | JOHN E THURSTON M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 401 S 15TH ST
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City | WORLAND
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State | WY
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Zip | 82401-3530
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Country | US
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Telephone | 307-347-2525
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Fax | 307-347-3949
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Provider Business Mailing Address
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Address Line | 401 S 15TH ST
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City | WORLAND
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State | WY
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Zip | 82401-3530
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Country | US
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Telephone | 307-347-2525
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Fax | 307-347-3949
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5442A
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License Number State | WY
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5008190-1205
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License Number State | UT
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