Provider Demographics
NPI:1629334701
Name:THOMPSON, NICHOLAS K (DO)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:K
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:918-488-6045
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6475 S YALE AVE STE 200
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-7816
Practice Address - Country:US
Practice Address - Phone:918-494-4462
Practice Address - Fax:918-494-4442
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2018-10-19
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Provider Licenses
StateLicense IDTaxonomies
OK5451207QS0010X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine