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General NPI Number Information
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NPI Number | 1477027498
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Entity Type | Individual
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Provider Name | CORY J THOMPSON NP
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Gender | Male
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Dates
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Enumeration Date | 01/12/2019
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Last Update Date | 01/12/2019
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Provider Practice Location Address
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Address Line | 652 S MEDICAL CENTER DR STE 420
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City | SAINT GEORGE
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State | UT
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Zip | 84790-7049
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Country | US
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Telephone | 435-669-2481
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Fax |
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Provider Business Mailing Address
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Address Line | 3179 E 2840 S
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City | SAINT GEORGE
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State | UT
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Zip | 84790-5148
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Country | US
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Telephone | 435-669-2481
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7370850-4405
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License Number State | UT
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