MEDICARE: DR. RICHARD GRAY TOMPSON M.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
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	MD 102941	MO

Other Identifiers

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

General Provider Information

NPI Number	:	1245235456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD GRAY TOMPSON M.D.

Provider Business Mailing Address
First Line	:	1410 DOCTORS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-4754
Country	:	US
Telephone Number	:	417-256-2225
Fax Number	:	417-256-2373

Provider Business Practice Location Address
First Line	:	1410 DOCTORS DR
Second Line	:
City	:	WEST PLAINS
State	:	MO
Zip	:	65775-4754
Country	:	US
Telephone Number	:	417-256-2225
Fax Number	:	417-256-2373

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2005
Last Update Date	:	08/02/2016

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