Provider Demographics
NPI:1487924205
Name:THOMPSON, ABBY ELIZABETH (OD)
Entity type:Individual
Prefix:DR
First Name:ABBY
Middle Name:ELIZABETH
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ABBY
Other - Middle Name:ELIZABETH
Other - Last Name:GUILBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:3311 GUMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-1934
Mailing Address - Country:US
Mailing Address - Phone:605-580-1366
Mailing Address - Fax:
Practice Address - Street 1:3311 GUMWOOD DR
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-1934
Practice Address - Country:US
Practice Address - Phone:605-580-1366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-10
Last Update Date:2012-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2248152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDTA2248OtherOPTOMETRIC LICENSE NUMBER