| Doctor Name: | JIMMIE THOMPSON |
| NPI Number: | 1043342868 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | PA-677 |
| Business Practice Address: | 1151 Hospital Way Suite D Pocatello, ID - 832015091 |
| Business Phone Number: | 2082334455 |
| Business Fax Number: | |
| Mailing Address: | 98 Poplar St, BLACKFOOT |
| State: | ID |
| Postal Code: | 832211758 |
| Phone Number: | 2087854100 |
| Fax Number: | |
| NPI Enumeration Date: | 03/09/2007 |
| NPI Last Update Date: | 07/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA-677 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |