MEDICARE: THOMAS H THOMPSON MD PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	MD13952	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200046321	OTHER	OR	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023200953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS H THOMPSON MD PC

Provider Business Mailing Address
First Line	:	2508 NW MEDICAL PARK DR
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-5510
Country	:	US
Telephone Number	:	541-677-1256
Fax Number	:	541-673-1160

Provider Business Practice Location Address
First Line	:	2508 NW MEDICAL PARK DR
Second Line	:
City	:	ROSEBURG
State	:	OR
Zip	:	97471-5510
Country	:	US
Telephone Number	:	541-677-1256
Fax Number	:	541-673-1160

Authorized Official
Title or Position	:	SECRETARY/OFFICE MANAGER
Name	:	NANCY ELIZABETH THOMPSON
Credential	:
Telephone Number	:	541-677-1256

Provider Enumeration Date	:	08/14/2007
Last Update Date	:	02/11/2010

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