Provider Demographics
NPI:1790708410
Name:THOMPSON, JOHN SPENCER (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SPENCER
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:825 NE 10TH ST
Mailing Address - Street 2:STE. 1430
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5417
Mailing Address - Country:US
Mailing Address - Phone:405-271-3016
Mailing Address - Fax:405-271-9240
Practice Address - Street 1:825 NE 13TH ST
Practice Address - Street 2:OUPB 1430
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5005
Practice Address - Country:US
Practice Address - Phone:405-271-3016
Practice Address - Fax:405-271-9240
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK249692085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology