Provider Demographics
NPI:1528021532
Name:THOMPSON, HARVEY (OD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 S COLLEGE AVE STE 180
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-2660
Mailing Address - Country:US
Mailing Address - Phone:970-498-8388
Mailing Address - Fax:970-498-8380
Practice Address - Street 1:3500 S COLLEGE AVE STE 180
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-2660
Practice Address - Country:US
Practice Address - Phone:970-498-8388
Practice Address - Fax:970-498-8380
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9928999152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COLTD478448Medicaid
COC478458Medicare ID - Type Unspecified
COLTD478448Medicaid