Provider Demographics
NPI:1568626703
Name:THOMPSON, KERI J (DO)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:J
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:46325 W 12 MILE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2456
Mailing Address - Country:US
Mailing Address - Phone:248-465-1200
Mailing Address - Fax:248-465-2850
Practice Address - Street 1:46325 W 12 MILE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377-2456
Practice Address - Country:US
Practice Address - Phone:248-465-1200
Practice Address - Fax:248-465-2850
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIL1380056207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology