MEDICARE: SHARON R. THOMPSON PC

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	261QM1300X	Multi-Specialty Clinic/Center	35615	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1265458897	OTHER	AZ	CPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952689424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHARON R. THOMPSON PC

Provider Business Mailing Address
First Line	:	2034 N 3RD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1403
Country	:	US
Telephone Number	:	602-288-2779
Fax Number	:

Provider Business Practice Location Address
First Line	:	2034 N 3RD ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85004-1403
Country	:	US
Telephone Number	:	602-288-2779
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. SHARON THOMPSON
Credential	:	MD, MPH
Telephone Number	:	602-288-0779

Provider Enumeration Date	:	08/01/2011
Last Update Date	:	09/01/2011

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