1932362191 NPI number — GEORGE G. THOMSON, MD

Table of content: (NPI 1932362191)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932362191 NPI number — GEORGE G. THOMSON, MD

Organization/Personal Information

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

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932362191
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/08/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
69 MAIN 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:
03458-2419
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-924-3644
Provider Business Mailing Address Fax Number:
603-924-7420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
69 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PETERBOROUGH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03458-2419
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:
07/08/2008

Additional Information

Authorized Official

Authorized Official Last Name:
THOMSON
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
GRAHAM
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
603-924-3644

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: NH8923 , 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)

  • Identifier: 0109069YONH09 . This is a "ANTHEM BLUE CROSS & BLUE SHIELD" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 426381 . This is a "TUFTS" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: AA93229 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30005649 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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