Doctor Name: | MARK A THOMPSON |
NPI Number: | 1023244563 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DVM |
License Number: | 4501-050 |
Business Practice Address: | N4415a Us Highway 45 Eden, WI - 530191220 |
Business Phone Number: | 9204773003 |
Business Fax Number: | 9204774001 |
Mailing Address: | N4415a Us Highway 45, EDEN |
State: | WI |
Postal Code: | 530191220 |
Phone Number: | 9204773003 |
Fax Number: | 9204774001 |
NPI Enumeration Date: | 06/10/2009 |
NPI Last Update Date: | 10/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174M00000X |
License Number: | 4501-050 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Veterinarian |
Taxonomy Specialization: | |
Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |