Provider Demographics
NPI:1205816790
Name:THAMPY, K. GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:K.
Middle Name:GEORGE
Last Name:THAMPY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:K.
Other - Middle Name:GEORGE
Other - Last Name:THAMPY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:10004 KENNERLY RD
Mailing Address - Street 2:SUITE 160B
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2141
Mailing Address - Country:US
Mailing Address - Phone:314-842-1588
Mailing Address - Fax:314-543-5298
Practice Address - Street 1:10004 KENNERLY RD
Practice Address - Street 2:SUITE 160B
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2141
Practice Address - Country:US
Practice Address - Phone:314-842-1588
Practice Address - Fax:314-543-5298
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO112762207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205794100Medicaid
MO2205302OtherUNITED HEALTH CARE
MO160098OtherBLUE SHIELD OF MISSOURI
MO4655094OtherCIGNA
MO7506235OtherAETNA
MO11843OtherESSENCE
MO157742OtherBLUE SHIELD OF MO -EDMC
MO2011289OtherFIRST HEALTH
MO486623OtherHEALTHLINK
MO110235730OtherRAILROAD MEDICARE
MOH58536Medicare UPIN
MO205794100Medicaid