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NPI Code Detail

MEDICARE: LESLIE THOMPSON PA-C

MEDICARE: LESLIE THOMPSON PA-C
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
1363A00000XPhysician AssistantPA652NV

Other Identifiers

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

General Provider Information

NPI Number : 1841207669
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE THOMPSON PA-C
Provider Business Mailing Address
First Line : 3325 RESEARCH WAY
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7913
Country : US
Telephone Number : 775-888-6610
Fax Number : 775-888-4904
Provider Business Practice Location Address
First Line : 3325 RESEARCH WAY
Second Line :
City : CARSON CITY
State : NV
Zip : 89706-7913
Country : US
Telephone Number : 775-887-5140
Fax Number : 775-887-5143
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2006
Last Update Date : 08/27/2012

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