MEDICARE: THOMAS F NAGY O.D.

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
1	152W00000X	Optometrist	4131/T1002	OH
2	152W00000X	Optometrist	1443DT	KY
3	152W00000X	Optometrist	OPT.004131	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000122757	OTHER		ANTHEM

General Provider Information

NPI Number	:	1952410532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS F NAGY O.D.

Provider Business Mailing Address
First Line	:	1950 OLD GALLOWS RD STE 520
Second Line	:
City	:	VIENNA
State	:	VA
Zip	:	22182-3970
Country	:	US
Telephone Number	:	703-847-8899
Fax Number	:	571-223-6780

Provider Business Practice Location Address
First Line	:	3600 TOWNE BLVD STE B
Second Line	:
City	:	MIDDLETOWN
State	:	OH
Zip	:	45005-5543
Country	:	US
Telephone Number	:	513-424-5217
Fax Number	:	513-424-0205

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	02/16/2022

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Directions to “ THOMAS F NAGY O.D.” Practice Location

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