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NPI Code Detail

MEDICARE: JOHN W THOMPSON D.O.

MEDICARE: JOHN W THOMPSON D.O.
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
1207RG0100XGastroenterology Physician1385ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1568448637
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN W THOMPSON D.O.
Provider Business Mailing Address
First Line : 2 LIVEWELL DR
Second Line : THE MEDICAL GROUP DEPT. OF GOODALL HOSPITAL
City : KENNEBUNK
State : ME
Zip : 04043-6762
Country : US
Telephone Number : 207-985-7174
Fax Number : 207-985-1304
Provider Business Practice Location Address
First Line : 2 LIVEWELL DR
Second Line : THE MEDICAL GROUP DEPT. OF GOODALL HOSPITAL
City : KENNEBUNK
State : ME
Zip : 04043-6762
Country : US
Telephone Number : 207-985-7174
Fax Number : 207-985-1304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/20/2005
Last Update Date : 12/29/2011

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