MEDICARE: ROBIN K THOMPSON 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	207V00000X	Obstetrics & Gynecology Physician	RT053034	MI

General Provider Information

NPI Number	:	1356331169
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN K THOMPSON M.D.

Provider Business Mailing Address
First Line	:	64586 BALK RD
Second Line	:
City	:	STURGIS
State	:	MI
Zip	:	49091-9621
Country	:	US
Telephone Number	:	269-651-9048
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 S LAKEVIEW ST
Second Line	:
City	:	STURGIS
State	:	MI
Zip	:	49091-2371
Country	:	US
Telephone Number	:	269-651-3174
Fax Number	:	269-659-0182

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	07/08/2007

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