Provider Demographics
NPI:1376626317
Name:THOMPSON EYE CLINIC
Entity Type:Organization
Organization Name:THOMPSON EYE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:913-631-7700
Mailing Address - Street 1:11005 W 60TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66203-2913
Mailing Address - Country:US
Mailing Address - Phone:913-631-7700
Mailing Address - Fax:913-631-5656
Practice Address - Street 1:11005 W 60TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-2913
Practice Address - Country:US
Practice Address - Phone:913-631-7700
Practice Address - Fax:913-631-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1754152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSH37803Medicare UPIN