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General NPI Number Information
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NPI Number | 1245235456
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Entity Type | Individual
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Provider Name | RICHARD GRAY TOMPSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2005
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Last Update Date | 08/02/2016
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Provider Practice Location Address
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Address Line | 1410 DOCTORS DR
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City | WEST PLAINS
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State | MO
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Zip | 65775-4754
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Country | US
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Telephone | 417-256-2225
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Fax | 417-256-2373
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Provider Business Mailing Address
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Address Line | 1410 DOCTORS DR
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City | WEST PLAINS
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State | MO
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Zip | 65775-4754
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Country | US
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Telephone | 417-256-2225
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Fax | 417-256-2373
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD 102941
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License Number State | MO
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