Healthcare Provider Details

I. General information

NPI: 1871605097
Provider Name (Legal Business Name): THOMAS EDWARD NYE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 11/04/2021
Certification Date: 11/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

644 HIGH ST
HAMILTON OH
45011-6005
US

IV. Provider business mailing address

644 HIGH ST
HAMILTON OH
45011-6005
US

V. Phone/Fax

Practice location:
  • Phone: 513-887-1100
  • Fax: 513-887-2671
Mailing address:
  • Phone: 513-887-1100
  • Fax: 513-887-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number3955
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number3955
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number3955
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number3955
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number3955
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number3955
License Number StateOH
# 7
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3955
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: