Organization
ALICIA THOMPSON MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICIA D THOMPSON MD (OWNER)
(405) 657-4537
Entity
Organization
Contact information
Practice address
15005 SALEM CREEK RD, EDMOND, OK 73013-2455
(405) 657-4537
(405) 347-7617
Mailing address
15005 SALEM CREEK RD, EDMOND, OK 73013-2455
(405) 657-4537
(405) 347-7617
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
25776
OK
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091050022
—
MO
05
—
100125890A
—
OK
01
—
108326
MEDICAL LISCENSE
MO
01
—
25776
LISCENSE
OK
Enumeration date
08/25/2011
Last updated
02/07/2021
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