Individual
SPENCER MACKENZEE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 S BLISS AVE, TAHLEQUAH, OK 74464-2512
(580) 372-4612
Mailing address
17964 W GRANDVIEW RD, TAHLEQUAH, OK 74464-1012
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9228
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/05/2022
Last updated
07/16/2025
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