Provider Demographics
NPI:1962491894
Name:THOMPSON, AMY F (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:F
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4905 W TILGHMAN ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-9130
Mailing Address - Country:US
Mailing Address - Phone:484-866-9583
Mailing Address - Fax:610-366-1147
Practice Address - Street 1:4905 W TILGHMAN ST
Practice Address - Street 2:SUITE 250
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-9130
Practice Address - Country:US
Practice Address - Phone:484-866-9583
Practice Address - Fax:610-366-1147
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD067636L207L00000X
NC9801334207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0291795000OtherINDEP. BLUE CROSS
PA1095655OtherAMERIHEALTH MERCY
PA0506111OtherKEYSTONE CENTRAL
PA506111OtherHIGHMARK
PA000000099497OtherTHREE RIVERS
PA0017370950001Medicaid
PA30000804OtherKEYSTONE MERCY
PA01737095OtherGATEWAY
PAG87008Medicare UPIN
PA1095655OtherAMERIHEALTH MERCY
PA0017370950001Medicaid