Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 11927 | NV |
N | 207PE0004X | Emergency Medical Services | 11927 | NV |
NPI | 1205927258 |
---|---|
Provider Name | Stephen C. Thompson |
First Address | Reno, NV 89502-1304 |
Second Address | Reno, NV 89502-1576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 21/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100510418 | (05) | NV |
A042 | TRICARE (01) | NV |
A045 | TRICARE (01) | NV |
A050 | TRICARE (01) | NV |
I29710 | (02) | NV |
NV4016 | BC/BS (01) | NV |