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NPI Code Detail

MEDICARE: DR. THOMAS F TERRY OD

MEDICARE: DR. THOMAS F TERRY OD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist030-0000167VT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1030264105OTHERBANKER'S LIFE
20908741YOVT01OTHERNHANTHEM
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4030264105OTHERAARP
5953283OTHERMVP
6030264105OTHERCIGNA
7030264105OTHERVSP
8VT0167OTHEREYE MED

General Provider Information

NPI Number : 1588650568
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS F TERRY OD
Provider Business Mailing Address
First Line : 128 N MAIN ST
Second Line :
City : WHITE RIVER JUNCTION
State : VT
Zip : 05001-7056
Country : US
Telephone Number : 802-295-3300
Fax Number : 802-295-6581
Provider Business Practice Location Address
First Line : 128 N MAIN ST
Second Line :
City : WHITE RIVER JUNCTION
State : VT
Zip : 05001-7056
Country : US
Telephone Number : 802-295-3300
Fax Number : 802-295-6581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 12/16/2011

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