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General NPI Number Information
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NPI Number | 1083145668
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Entity Type | Individual
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Provider Name | DOUGLAS MICHAEL THOMPSON D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2017
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Last Update Date | 07/14/2021
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Provider Practice Location Address
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Address Line | 8040 PRINCETON GLENDALE RD
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City | WEST CHESTER
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State | OH
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Zip | 45069-5802
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Country | US
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Telephone | 513-246-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 W LEXINGTON SUITE 100
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City | CINCINNATI
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State | OH
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Zip | 45212-3589
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 34.014544
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License Number State | OH
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