1174550032 NPI number — GEORGE GRAHAM THOMSON MD

Table of content: GEORGE GRAHAM THOMSON MD (NPI 1174550032)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174550032 NPI number — GEORGE GRAHAM THOMSON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
THOMSON
Provider First Name:
GEORGE
Provider Middle Name:
GRAHAM
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
THOMSON
Provider Other First Name:
GEORDIE
Provider Other Middle Name:
GRAHAM
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1174550032
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 RIVER ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PETERBOROUGH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03458-1405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-924-3644
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
174 CONCORD ST
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
PETERBOROUGH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03458-1222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-924-3644
Provider Business Practice Location Address Fax Number:
603-924-7420
Provider Enumeration Date:
06/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X , with the licence number:  8923 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 8923 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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