Healthcare Provider Details

I. General information

NPI: 1326455445
Provider Name (Legal Business Name): SYBLE THOMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2014
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 N 14TH AVE
DODGE CITY KS
67801-3413
US

IV. Provider business mailing address

1700 N 14TH AVE
DODGE CITY KS
67801-3413
US

V. Phone/Fax

Practice location:
  • Phone: 620-225-6140
  • Fax: 620-225-8813
Mailing address:
  • Phone: 620-225-6140
  • Fax: 620-225-8813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number11269
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: