MEDICARE: DR. ALLISON H THOMPSON MD

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
1	208000000X	Pediatrics Physician	38360	TN
2	208000000X	Pediatrics Physician	26228	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336107416
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALLISON H THOMPSON MD

Provider Business Mailing Address
First Line	:	6465 S YALE AVE
Second Line	:	# 715
City	:	TULSA
State	:	OK
Zip	:	74136-7823
Country	:	US
Telephone Number	:	918-481-4750
Fax Number	:	918-481-4755

Provider Business Practice Location Address
First Line	:	6465 S YALE AVE
Second Line	:	# 715
City	:	TULSA
State	:	OK
Zip	:	74136-7823
Country	:	US
Telephone Number	:	918-481-4750
Fax Number	:	918-481-4755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2006
Last Update Date	:	03/19/2014

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