Provider Demographics
NPI:1164577318
Name:THOMPSON, JANET A (AUDIOLOGIST)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 W 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4602
Mailing Address - Country:US
Mailing Address - Phone:405-624-8605
Mailing Address - Fax:405-624-8606
Practice Address - Street 1:116 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4602
Practice Address - Country:US
Practice Address - Phone:405-624-8605
Practice Address - Fax:405-624-8606
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK103174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist