Provider Demographics
NPI:1043482037
Name:THORNE, ALICIA HOPE (DO)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:HOPE
Last Name:THORNE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:HOPE
Other - Last Name:PARKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:193 W SCHROCK RD
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43081-2890
Mailing Address - Country:US
Mailing Address - Phone:614-392-5160
Mailing Address - Fax:614-392-5161
Practice Address - Street 1:193 W SCHROCK RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2890
Practice Address - Country:US
Practice Address - Phone:614-392-5160
Practice Address - Fax:614-392-5161
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-30
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-009255207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0053605Medicaid
OHH011650Medicare PIN