Provider Demographics
NPI:1740393156
Name:THOMPSON, ALAN K (OD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:K
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 1:155 BORTHWICK AVE
Mailing Address - Street 2:SUITE 200 EAST
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-7156
Mailing Address - Country:US
Mailing Address - Phone:603-436-1773
Mailing Address - Fax:603-427-0655
Practice Address - Street 1:155 BORTHWICK AVE
Practice Address - Street 2:SUITE 200 EAST
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-7156
Practice Address - Country:US
Practice Address - Phone:603-436-1773
Practice Address - Fax:603-427-0655
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0776152W00000X, 152WC0802X, 152WX0102X
MA2577152W00000X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH31468YMedicare UPIN
NHTH-RE8632Medicare ID - Type Unspecified