Provider Demographics
NPI:1922012160
Name:THOMPSON, DORI ROBIN (MD)
Entity Type:Individual
Prefix:
First Name:DORI
Middle Name:ROBIN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6121 COLERAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45239-6417
Mailing Address - Country:US
Mailing Address - Phone:513-354-2466
Mailing Address - Fax:513-906-5477
Practice Address - Street 1:6121 COLERAIN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45239-6417
Practice Address - Country:US
Practice Address - Phone:513-354-2466
Practice Address - Fax:513-906-5477
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35077931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35077931OtherOH MEDICAL LICENSE
OH2274702Medicaid
OH4289371Medicare PIN