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General NPI Number Information
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NPI Number | 1972710010
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Entity Type | Organization
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Legal Business Name | CHAD L. THOMPSON, DPM, LLC
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/03/2009
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Provider Practice Location Address
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Address Line | 2730 S VAL VISTA DR SUITE 175
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City | GILBERT
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State | AZ
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Zip | 85295-1683
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Country | US
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Telephone | 480-812-3636
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Fax | 480-812-3637
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Provider Business Mailing Address
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Address Line | 2730 S VAL VISTA DR SUITE 175
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City | GILBERT
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State | AZ
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Zip | 85295-1683
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Country | US
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Telephone | 480-812-3636
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Fax | 480-812-3637
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHAD L. THOMPSON
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Credential | D.P.M.
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Telephone | 480-812-3636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 0578
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License Number State | AZ
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