Provider Demographics
NPI:1497864060
Name:THOMPSON, HARVEY ALLEN
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:ALLEN
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:H.
Other - Middle Name:A
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC
Mailing Address - Street 1:419 NW 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:KS
Mailing Address - Zip Code:67410-2601
Mailing Address - Country:US
Mailing Address - Phone:785-263-1167
Mailing Address - Fax:
Practice Address - Street 1:419 NW 5TH ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:KS
Practice Address - Zip Code:67410-2601
Practice Address - Country:US
Practice Address - Phone:785-263-1167
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-03415111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS007152Medicare UPIN