Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | DR.0062263 | CO |
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | DR.0062263 | CO |
NPI | 1811331721 |
---|---|
Provider Name | Richard W. Thompson |
First Address | Denver, CO 80206-5246 |
Second Address | Parker, CO 80138-8506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2013 |
Last Update Date | 11/09/2020 |