MEDICARE: DR. JOHN RUTHERFORD THOMPSON MD

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	4282	NV

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255327094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN RUTHERFORD THOMPSON MD

Provider Business Mailing Address
First Line	:	3233 W CHARLESTON BLVD
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1938
Country	:	US
Telephone Number	:	702-388-1008
Fax Number	:	702-410-8451

Provider Business Practice Location Address
First Line	:	3233 W CHARLESTON BLVD
Second Line	:	SUITE 101
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1938
Country	:	US
Telephone Number	:	702-388-1008
Fax Number	:	702-410-8451

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

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	10/19/2010

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