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Alicia Thompson MD PLLC

Organization Active NPI Child & Adolescent Psychiatry Physician · Edmond, OK

NPI 1043590722 · NPPES record last updated Feb 7, 2021

Key facts

NPI
1043590722
Entity type
Organization (NPI type 2)
Primary specialty
Child & Adolescent Psychiatry Physician 2084P0804X
License
25776 (OK)
Legal business name
ALICIA THOMPSON MD PLLC
Practice address
15005 Salem Creek Rd
Edmond, OK 73013-2455
Phone
(405) 657-4537
Fax
(405) 347-7617
NPI assigned
Aug 25, 2011
Organization subpart
No

Authorized official

Name
Dr. Alicia D Thompson, MD NPI 1053321596
Title
Owner
Phone
(405) 657-4537

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 2084P0804X 25776 OK Yes
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

15005 Salem Creek Rd
Edmond, OK 73013-2455

Mailing address

15005 Salem Creek Rd
Edmond, OK 73013-2455
Phone (405) 657-4537

Other identifiers

IdentifierTypeStateIssuer
091050022MedicaidMO
25776OtherOKLISCENSE
108326OtherMOMEDICAL LISCENSE
100125890AMedicaidOK

Other providers in Edmond, OK

All providers in Edmond, OK · Child & Adolescent Psychiatry Physician in Oklahoma

Sources for this page

Verify at the official NPI Registry.