Provider Demographics
NPI:1083799670
Name:THOMPSON, KAREN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:S
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 PUNAHOU ST.
Mailing Address - Street 2:BASEMENT
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826
Mailing Address - Country:US
Mailing Address - Phone:808-983-8581
Mailing Address - Fax:808-973-1401
Practice Address - Street 1:1309 PUNAHOU ST.
Practice Address - Street 2:BASEMENT
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826
Practice Address - Country:US
Practice Address - Phone:808-983-8581
Practice Address - Fax:808-973-1401
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD11169207ZP0102X, 207ZP0213X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Not Answered207ZP0213XAllopathic & Osteopathic PhysiciansPathologyPediatric Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI226282OtherHMSA
HI49917016Medicaid
HIMD11169OtherQUEENS
HI52932Medicare ID - Type Unspecified
HI49917016Medicaid