Provider Demographics
NPI:1114346905
Name:THOMPSON, KENNETH ROBERT III (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:ROBERT
Last Name:THOMPSON
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:231 ALBERT SABIN WAY
Mailing Address - Street 2:MSB 1654
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0769
Mailing Address - Country:US
Mailing Address - Phone:513-558-8114
Mailing Address - Fax:513-558-5791
Practice Address - Street 1:234 GOODMAN ST
Practice Address - Street 2:CENTER FOR EMERGENCY CARE
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2364
Practice Address - Country:US
Practice Address - Phone:513-558-8114
Practice Address - Fax:513-558-5791
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.130997207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program