MEDICARE: ROBERT BERNARD 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	207VG0400X	Gynecology Physician	16028	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	ASC1019	OTHER	KY	MEDICARE ASC GROUP
4	CB5773	OTHER	KY	RR MEDICARE GROUP #
6	4000501	OTHER	KY	MEDICARE LAB GROUP

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1801819602
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT BERNARD THOMPSON M.D.

Provider Business Mailing Address
First Line	:	160 N EAGLE CREEK DR
Second Line	:	SUITE 400
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2121
Country	:	US
Telephone Number	:	859-258-5220
Fax Number	:	859-258-5405

Provider Business Practice Location Address
First Line	:	160 N EAGLE CREEK DR
Second Line	:	SUITE 400
City	:	LEXINGTON
State	:	KY
Zip	:	40509-2121
Country	:	US
Telephone Number	:	859-258-5220
Fax Number	:	859-258-5405

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	11/02/2007

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Directions to “ ROBERT BERNARD THOMPSON M.D.” Practice Location

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