Provider Demographics
NPI:1992908131
Name:CARYL A. THOMPSON
Entity type:Organization
Organization Name:CARYL A. THOMPSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARYL
Authorized Official - Middle Name:A
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA OTR
Authorized Official - Phone:907-344-8891
Mailing Address - Street 1:1120 HUFFMAN RD
Mailing Address - Street 2:SUITE 24, BOX 412
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99515-3561
Mailing Address - Country:US
Mailing Address - Phone:907-344-8891
Mailing Address - Fax:
Practice Address - Street 1:145 OCEAN PARK DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-3402
Practice Address - Country:US
Practice Address - Phone:907-344-8891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine