Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 027916 | CT |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 027916 | CT |
NPI | 1194791558 |
---|---|
Provider Name | Jeffrey Thomson |
First Address | Hartford, CT 06106-3322 |
Second Address | Hartford, CT 06106-3322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 15/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001279167 | (05) | CT |
F82536 | (02) | CT |