Provider Demographics
NPI:1295489672
Name:THOMPSON, DOROTHY IRICK (CRNP)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:IRICK
Last Name:THOMPSON
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 CARMICHAEL WAY
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-3671
Mailing Address - Country:US
Mailing Address - Phone:334-277-7665
Mailing Address - Fax:
Practice Address - Street 1:1230 CARMICHAEL WAY
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-3671
Practice Address - Country:US
Practice Address - Phone:133-444-0602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1-144018207Q00000X
AL1-144018207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine