Provider Demographics
NPI:1699743690
Name:THOMPSON, CATHERINE E (DO)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:E
Last Name:THOMPSON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:550 N UNIVERSITY BLVD.
Practice Address - Street 2:UH 1501
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202-5149
Practice Address - Country:US
Practice Address - Phone:317-948-1310
Practice Address - Fax:317-948-0503
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC889207Q00000X
IN02003847A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200343490Medicaid
INP01356989Medicare PIN
INM400065129Medicare PIN
INP01111768 RR MCMedicare PIN
INM400050078Medicare PIN
IN200343490Medicaid