Provider Demographics
NPI:1801002605
Name:THOMPSON, AMY MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:MARIE
Last Name:THOMPSON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GRANBURG CIR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3002
Mailing Address - Country:US
Mailing Address - Phone:253-592-4389
Mailing Address - Fax:
Practice Address - Street 1:680 OYSTER POINT RD STE 105
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4570
Practice Address - Country:US
Practice Address - Phone:757-668-4851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE509208000000X
VA0102209017208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics