Provider Demographics
NPI:1427162395
Name:THOMPSON, ANGELIA F (MD)
Entity type:Individual
Prefix:
First Name:ANGELIA
Middle Name:F
Last Name:THOMPSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3290 BLAZER PKWY STE 100
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2169
Mailing Address - Country:US
Mailing Address - Phone:859-264-0445
Mailing Address - Fax:859-264-0447
Practice Address - Street 1:3290 BLAZER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2169
Practice Address - Country:US
Practice Address - Phone:859-264-0445
Practice Address - Fax:859-264-0447
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34194207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64341944Medicaid
KY000000496251OtherBCBS
KYG75312Medicare UPIN
KYP00389506Medicare PIN
KY00197Medicare PIN
KY0169Medicare PIN
KY000000496251OtherBCBS