Provider Demographics
NPI:1912789116
Name:THOMPSON, DOUGLAS NEWPORT (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:NEWPORT
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4318 ALEXANDRIA PIKE STE B
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:KY
Mailing Address - Zip Code:41076-2041
Mailing Address - Country:US
Mailing Address - Phone:859-474-8159
Mailing Address - Fax:
Practice Address - Street 1:4318 ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:KY
Practice Address - Zip Code:41076-2040
Practice Address - Country:US
Practice Address - Phone:859-474-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2360DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist