Individual
LISA KISLING THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
105 W 86TH ST, NEW YORK, NY 10024-3444
(646) 863-1411
Mailing address
14286 BEACH HEATHER CT, PENSACOLA, FL 32507-9712
(719) 310-2117
(859) 545-5035
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DR.0063179
CO
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
C0426
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
03/27/2023
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