Provider Demographics
NPI:1912109869
Name:THOMPSON, TOBY NEAL (PHARM D)
Entity type:Individual
Prefix:DR
First Name:TOBY
Middle Name:NEAL
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 3 BOX 33
Mailing Address - Street 2:
Mailing Address - City:COMANCHE
Mailing Address - State:OK
Mailing Address - Zip Code:73529-9513
Mailing Address - Country:US
Mailing Address - Phone:580-439-8270
Mailing Address - Fax:580-439-2357
Practice Address - Street 1:513 HILLERY RD
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:OK
Practice Address - Zip Code:73529-1200
Practice Address - Country:US
Practice Address - Phone:580-439-8869
Practice Address - Fax:580-439-2357
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12914183500000X
TX40206183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist