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Individual

DR. DUSTIN ALLEN THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
1600 W UNIVERSITY BLVD, DURANT, OK 74701-3094
(580) 924-5500
Mailing address
1600 W UNIVERSITY BLVD, DURANT, OK 74701-3094

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
6780
OK
207Q00000X
Family Medicine Physician
Primary
6780
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200852000A
OK
Enumeration date
06/26/2018
Last updated
11/11/2019
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