Doctor Name: | MR. THOMAS MARK THOMPSON |
NPI Number: | 1306978077 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | 17807 |
Business Practice Address: | 216 W Central Blvd Anadarko, OK - 730053406 |
Business Phone Number: | 4052473391 |
Business Fax Number: | 4052473391 |
Mailing Address: | 216 W Central Blvd, Po Box 125 ANADARKO |
State: | OK |
Postal Code: | 730053406 |
Phone Number: | 4052473391 |
Fax Number: | 4052473391 |
NPI Enumeration Date: | 03/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | 17807 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |