Provider Demographics
NPI:1669449401
Name:THOMPSON, ROBERT HENRY III (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:HENRY
Last Name:THOMPSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2058 S DOBSON RD
Mailing Address - Street 2:#10
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85202-6455
Mailing Address - Country:US
Mailing Address - Phone:480-730-0707
Mailing Address - Fax:480-730-6893
Practice Address - Street 1:2058 S DOBSON RD
Practice Address - Street 2:#10
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-6455
Practice Address - Country:US
Practice Address - Phone:480-730-0707
Practice Address - Fax:480-730-6893
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2008-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ10936207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D44581Medicare UPIN