Provider Demographics
NPI:1194792275
Name:THOMPSON, ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:THOMPSON
Suffix:
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 1:9201 PARALLEL PKWY
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-1510
Mailing Address - Country:US
Mailing Address - Phone:913-334-4110
Mailing Address - Fax:
Practice Address - Street 1:9201 PARALLEL PKWY
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-1510
Practice Address - Country:US
Practice Address - Phone:913-334-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR9A022085R0202X, 2085B0100X
KS04-198912085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100123080DMedicaid
MO300089662OtherRR MEDICARE
MO202824405Medicaid
MO300089662OtherRR MEDICARE
MOC51576Medicare UPIN
KS100123080DMedicaid
MO300089662Medicare PIN
KS016380001Medicare PIN
KSK676912AMedicare PIN
MO0566912BMedicare PIN