Provider Demographics
NPI:1386634731
Name:THOMPSON, KARA LEE A (DO)
Entity type:Individual
Prefix:
First Name:KARA LEE
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S FILLMORE ST
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1619
Mailing Address - Country:US
Mailing Address - Phone:641-342-5351
Mailing Address - Fax:642-342-5369
Practice Address - Street 1:800 S FILLMORE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1619
Practice Address - Country:US
Practice Address - Phone:641-342-5351
Practice Address - Fax:642-342-5369
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA03518207P00000X
IADO-035182083B0002X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083B0002XAllopathic & Osteopathic PhysiciansPreventive MedicineObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00639295OtherRAILROAD MEDICARE
IA546840004Medicare PIN
H90589Medicare UPIN
IA546830003Medicare PIN