Provider Demographics
NPI:1457357253
Name:THOMPSON, STEPHEN M (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:865 LINCOLN RD
Mailing Address - Street 2:STE L10
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-4159
Mailing Address - Country:US
Mailing Address - Phone:563-355-9191
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:210 W 53RD ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52806-2251
Practice Address - Country:US
Practice Address - Phone:563-386-8250
Practice Address - Fax:563-386-3211
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2021-09-24
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Provider Licenses
StateLicense IDTaxonomies
IA02662207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0159OtherJOHN DEERE HEALTH PLAN
034795OtherHEALTH ALLIANCE
20116OtherIOWA HEALTH SOLUTIONS
4796890009OtherDMERC
40209OtherWELLMARK HEALTH PLANS
IL5074773Medicaid
IA0159OtherJOHN DEERE HEALTH PLAN
20116OtherIOWA HEALTH SOLUTIONS