Healthcare Provider Details

I. General information

NPI: 1467620872
Provider Name (Legal Business Name): THOMAS OCULAR PROSTHETICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 KIRBY PKWY STE. 102
MEMPHIS TN
38138-3653
US

IV. Provider business mailing address

1900 KIRBY PKWY STE. 102
MEMPHIS TN
38138-3653
US

V. Phone/Fax

Practice location:
  • Phone: 901-753-4724
  • Fax: 901-759-5920
Mailing address:
  • Phone: 901-753-4724
  • Fax: 901-759-5920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT THOMAS
Title or Position: PRESIDENT/ OWNER
Credential: BCO
Phone: 901-753-4724