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General NPI Number Information
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NPI Number | 1881890705
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Entity Type | Individual
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Provider Name | JACQUELINE J. THOMPSON O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 1481 W 10TH ST
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2803
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Country | US
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Telephone | 317-554-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 11486 ENCLAVE BLVD
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City | FISHERS
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State | IN
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Zip | 46038-1590
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Country | US
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Telephone | 317-694-8449
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18003464A
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License Number State | IN
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