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General NPI Number Information
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NPI Number | 1134111297
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Entity Type | Individual
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Provider Name | GILL P THOMAS OD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 204 E CAROLINA AVE
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City | CLINTON
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State | SC
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Zip | 29325-2523
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Country | US
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Telephone | 864-833-5355
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Fax | 864-833-7692
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Provider Business Mailing Address
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Address Line | 204 E CAROLINA AVE
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City | CLINTON
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State | SC
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Zip | 29325-2523
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Country | US
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Telephone | 864-833-5355
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Fax | 864-833-7692
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | DO7366
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License Number State | SC
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