=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265263933
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS ARMSTRONG V OD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2024
-----------------------------------------------------
Last Update Date | 10/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 703 RUTTER AVE
-----------------------------------------------------
City | KINGSTON
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 18704-4801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-288-7405
-----------------------------------------------------
Fax | 570-288-7406
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2661 RIVA RD STE 1030
-----------------------------------------------------
City | ANNAPOLIS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21401-7131
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 667-354-5528
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OEG004194
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------