Provider Demographics
NPI:1780613232
Name:THOMPSON, KARA BETH (MD)
Entity type:Individual
Prefix:DR
First Name:KARA
Middle Name:BETH
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 1:2516 Q ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:IN
Mailing Address - Zip Code:47421-4928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2516 Q ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:IN
Practice Address - Zip Code:47421-4928
Practice Address - Country:US
Practice Address - Phone:812-275-4228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40538207Q00000X
IN01067788A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100007580Medicaid
KYP400028316Medicare PIN
KYP400028319Medicare PIN
KYP400028320Medicare PIN
KYP400028317Medicare PIN
KYP400033166Medicare PIN
KYP400028323Medicare PIN
KYP400028318Medicare PIN