Provider Demographics
NPI:1457600496
Name:THOMPSON, NATHAN JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JAMES
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:DEPARTMENT OF PATHOLOGY MSC08 4640
Mailing Address - Street 2:BMSB ROOM 335 1 UNIVERSITY OF NEW MEXICO
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-4814
Mailing Address - Fax:505-272-8084
Practice Address - Street 1:DEPARTMENT OF PATHOLOGY BMSB 335 915 CAMINO
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-4814
Practice Address - Fax:505-272-8084
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2018-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3709390200000X
NM390200000X
IDFT5124843207ZP0102X
KS05-37875207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program