Provider Demographics
NPI:1154841336
Name:THOMPSON, RYAN JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:RYAN
Middle Name:JAMES
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9670 W COAL MINE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-4004
Mailing Address - Country:US
Mailing Address - Phone:303-932-2121
Mailing Address - Fax:
Practice Address - Street 1:9670 W COAL MINE AVE STE 200
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-4004
Practice Address - Country:US
Practice Address - Phone:303-932-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7255207Q00000X
390200000X
CODR.0072919207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program