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NPI Code Detail

MEDICARE: MATTIE THOMPSON

MEDICARE: MATTIE THOMPSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistCF521OK

General Provider Information

NPI Number : 1083304976
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATTIE THOMPSON
Provider Business Mailing Address
First Line : 4194 HIGHLAND DR
Second Line :
City : TAHLEQUAH
State : OK
Zip : 74464-1674
Country : US
Telephone Number : 918-688-0299
Fax Number :
Provider Business Practice Location Address
First Line : 6161 S YALE AVE
Second Line :
City : TULSA
State : OK
Zip : 74136-1902
Country : US
Telephone Number : 918-494-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2023
Last Update Date : 05/11/2026

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Directions to “ MATTIE THOMPSON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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