Individual
MICAH ELIZABETH THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1739 N 4TH ST, TERRE HAUTE, IN 47804-4002
(812) 242-3600
(812) 242-3620
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3600
(812) 242-3620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01053893A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224989
ANTHEM
—
01
—
080190486
RAILROAD MCARE PALAMETTO
—
05
—
200383930
—
IN
01
—
P00844304
RAILROAD MEDICARE
IN
Enumeration date
08/30/2006
Last updated
10/15/2010
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