Provider Demographics
NPI:1972897015
Name:THOMPSON, JAROD (BA BHRS)
Entity Type:Individual
Prefix:
First Name:JAROD
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:BA BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27753 S WELLING RD
Mailing Address - Street 2:
Mailing Address - City:WELLING
Mailing Address - State:OK
Mailing Address - Zip Code:74471-2202
Mailing Address - Country:US
Mailing Address - Phone:918-457-4999
Mailing Address - Fax:918-457-4104
Practice Address - Street 1:27753 S WELLING RD
Practice Address - Street 2:
Practice Address - City:WELLING
Practice Address - State:OK
Practice Address - Zip Code:74471-2202
Practice Address - Country:US
Practice Address - Phone:918-457-4999
Practice Address - Fax:918-457-4104
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator