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NPI Code Detail

MEDICARE: GARY THOMPSON MD

MEDICARE: GARY THOMPSON MD
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
1207P00000XEmergency Medicine Physician01042057IN
2207Q00000XFamily Medicine Physician01042057AIN

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 : 1932111598
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARY THOMPSON MD
Provider Business Mailing Address
First Line : PO BOX 781076
Second Line :
City : DETROIT
State : MI
Zip : 48278-1076
Country : US
Telephone Number : 317-528-4800
Fax Number :
Provider Business Practice Location Address
First Line : 1001 N MADISON AVE
Second Line :
City : GREENWOOD
State : IN
Zip : 46142-4135
Country : US
Telephone Number : 317-888-3508
Fax Number : 317-888-5968
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 03/12/2021

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Directions to “ GARY THOMPSON MD” Practice Location

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