Provider Demographics
NPI:1063514040
Name:THOMPSON, GEORGE SPROWLS JR (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:SPROWLS
Last Name:THOMPSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:511 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-2245
Mailing Address - Country:US
Mailing Address - Phone:785-550-2121
Mailing Address - Fax:888-723-2807
Practice Address - Street 1:7001 BLUE RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:RAYTOWN
Practice Address - State:MO
Practice Address - Zip Code:64133-5629
Practice Address - Country:US
Practice Address - Phone:816-966-0900
Practice Address - Fax:816-347-3029
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-234422084P0804X, 2084P0800X
MO20210260222084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100128600BMedicaid
KS041281Medicare ID - Type Unspecified
KSP00016297Medicare ID - Type UnspecifiedRAILROAD MEDICARE