Provider Demographics
NPI:1356378095
Name:THOMPSON, SCOTT KENT (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:KENT
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 N ROBINS DR STE 205
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-1181
Mailing Address - Country:US
Mailing Address - Phone:801-776-2220
Mailing Address - Fax:801-776-2534
Practice Address - Street 1:2255 N ROBINS DR STE 205
Practice Address - Street 2:
Practice Address - City:LAYTON
Practice Address - State:UT
Practice Address - Zip Code:84041-1181
Practice Address - Country:US
Practice Address - Phone:801-776-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2364702082S0099X
UT6103240-1205207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI33369Medicare UPIN
UT000060361Medicare PIN