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NPI Code Detail

MEDICARE: DR. ALICIA D THOMPSON M.D.

MEDICARE:  DR. ALICIA D THOMPSON  M.D.
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
12084P0804XChild & Adolescent Psychiatry Physician25776OK
22084P0800XPsychiatry Physician25776OK
32084P0800XPsychiatry Physician86908SC

Other Identifiers

General Provider Information

NPI Number : 1053321596
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALICIA D THOMPSON M.D.
Provider Business Mailing Address
First Line : 4001 N CLASSEN BLVD STE 200
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-2683
Country : US
Telephone Number : 405-251-7190
Fax Number :
Provider Business Practice Location Address
First Line : 2908 ASTORIA WAY
Second Line :
City : EDMOND
State : OK
Zip : 73034-5997
Country : US
Telephone Number : 405-378-2727
Fax Number : 480-383-6454
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2006
Last Update Date : 10/27/2025

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