MEDICARE: MR. ALBERT P 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	207Q00000X	Family Medicine Physician	MD13058	OR

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	:	1366587339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALBERT P THOMPSON M.D.

Provider Business Mailing Address
First Line	:	38505 BROOTEN RD
Second Line	:
City	:	PACIFIC CITY
State	:	OR
Zip	:	97135
Country	:	US
Telephone Number	:	503-965-6555
Fax Number	:	503-965-6800

Provider Business Practice Location Address
First Line	:	38505 BROOTEN RD
Second Line	:	SUITE A
City	:	PACIFIC CITY
State	:	OR
Zip	:	97135
Country	:	US
Telephone Number	:	503-965-6555
Fax Number	:	503-965-6800

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

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	03/25/2008

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