Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 1-144018 | AK |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 1-144018 | AL |
NPI | 1295489672 |
---|---|
Provider Name | Dr. Dorothy Irick Thompson |
First Address | Montgomery, AL 36106-3671 |
Second Address | Montgomery, AL 36106-3671 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/02/2022 |
Last Update Date | 04/02/2022 |