Provider Demographics
NPI:1144928474
Name:COMPTON, JOHN THOMAS (PA-C)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:THOMAS
Last Name:COMPTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1156 ROSE LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MO
Mailing Address - Zip Code:65610-8401
Mailing Address - Country:US
Mailing Address - Phone:417-848-9961
Mailing Address - Fax:
Practice Address - Street 1:550 S HUDSON AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605-2362
Practice Address - Country:US
Practice Address - Phone:417-678-5176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-16
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant