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Individual

RANDALL C THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4330 WORNALL RD, SUITE 2000, KANSAS CITY, MO 64111-5939
(816) 931-1883
(816) 756-3645
Mailing address
901 E 104TH ST, MAILSTOP 400S, KANSAS CITY, MO 64131
(816) 502-7117
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
207UN0901X
Nuclear Cardiology Physician
Primary
109525
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100181680C
KS
01
100181680D
MEDICAID - CUSHING
KS
05
100181680F
KS
05
100181680G
KS
05
208127209
MO
01
KA1021041
MEDICARE - CUSHING
KS
01
P00836137
RAILROAD MEDICARE
MO
01
P00842695
RAILROAD MEDICARE
KS
Enumeration date
05/04/2006
Last updated
11/16/2017
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