Organization
KISHORE THAMPY, M.D.,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KISHORE THAMPY M.D. (PRESIDENT)
(563) 584-2324
Entity
Organization
Contact information
Practice address
1955 US 1 S, ST AUGUSTINE, FL 32086-3708
(563) 599-9396
Mailing address
PO BOX 388320, CHICAGO, IL 60638-8320
(773) 767-4600
(776) 767-8320
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021604125
BLUE SHIELD
IL
05
—
036048133
—
IL
05
—
1133389
—
IA
01
—
260025865
RAILROAD MEDICARE
—
01
—
45495
BLUE SHIELD
IA
01
—
P00134680
RAILROAD MEDICARE
—
Enumeration date
07/12/2006
Last updated
08/28/2009
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