MEDICARE: MATTHEW GAGE 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	208M00000X	Hospitalist Physician	DR0068166	CO
2	208M00000X	Hospitalist Physician	79660	AZ
3	208M00000X	Hospitalist Physician	MD162291	OR

General Provider Information

NPI Number	:	1841427366
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW GAGE THOMPSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1189
Second Line	:
City	:	CORVALLIS
State	:	OR
Zip	:	97339-1189
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3043 NE 28TH ST
Second Line	:
City	:	LINCOLN CITY
State	:	OR
Zip	:	97367-4518
Country	:	US
Telephone Number	:	541-994-3661
Fax Number	:

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

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	05/13/2026

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