Provider Demographics
NPI:1336107416
Name:THOMPSON, ALLISON H (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:H
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 1:6465 S YALE AVE
Mailing Address - Street 2:# 715
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-7823
Mailing Address - Country:US
Mailing Address - Phone:918-481-4750
Mailing Address - Fax:918-481-4755
Practice Address - Street 1:6465 S YALE AVE
Practice Address - Street 2:# 715
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7823
Practice Address - Country:US
Practice Address - Phone:918-481-4750
Practice Address - Fax:918-481-4755
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2014-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38360208000000X
OK26228208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200207500BMedicaid
TN3893735Medicaid
TN3893735Medicaid
I05814Medicare UPIN