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NPI Code Detail

MEDICARE: DR. LARRY D THOMPSON O.D.

MEDICARE:  DR. LARRY D THOMPSON  O.D.
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
1152W00000XOptometrist1775WA

General Provider Information

NPI Number : 1033138631
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LARRY D THOMPSON O.D.
Provider Business Mailing Address
First Line : 4750 N DIVISION ST
Second Line : STE. 205
City : SPOKANE
State : WA
Zip : 99207-1402
Country : US
Telephone Number : 509-482-3100
Fax Number : 509-482-0680
Provider Business Practice Location Address
First Line : 4750 N DIVISION ST
Second Line : STE. 205
City : SPOKANE
State : WA
Zip : 99207-1402
Country : US
Telephone Number : 509-482-3100
Fax Number : 509-482-0680
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2006
Last Update Date : 07/08/2007

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Directions to “ DR. LARRY D THOMPSON O.D.” Practice Location

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