Individual
DR. KELLY BRIAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5395
(314) 268-6459
Mailing address
1320 SOUTH GRAND BLVD, O'DONNELL HALL/FIRST FLOOR, ST LOUIS, MO 63104
(662) 312-4640
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101249404
VA
208000000X
Pediatrics Physician
2019033201
MO
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
2019033201
MO
Other
Enumeration date
07/03/2009
Last updated
03/25/2025
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