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General NPI Number Information
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NPI Number | 1457356594
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Entity Type | Individual
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Provider Name | CRAIG R THOMPSON MD
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Gender | Male
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 03/03/2016
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Provider Practice Location Address
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Address Line | 180 KENNEDY MEMORIAL DR SUITE 304
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City | WATERVILLE
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State | ME
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Zip | 04901-4540
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Country | US
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Telephone | 207-861-7874
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Fax | 207-861-4646
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Provider Business Mailing Address
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Address Line | 222 KENNEDY MEMORIAL DR
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City | WATERVILLE
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State | ME
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Zip | 04901-4526
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Country | US
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Telephone | 207-861-3000
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Fax | 207-861-2385
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 22520
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 018638
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License Number State | ME
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