Provider Demographics
NPI:1033347919
Name:THOMPSON, CARA LEANNE (DO)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:LEANNE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 GROVE RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605-4295
Mailing Address - Country:US
Mailing Address - Phone:864-455-7887
Mailing Address - Fax:864-455-6875
Practice Address - Street 1:12455 E 100TH ST N STE 220
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-4675
Practice Address - Country:US
Practice Address - Phone:918-274-5555
Practice Address - Fax:918-302-6329
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL1278207V00000X
OK5449207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology