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General NPI Number Information
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NPI Number | 1376696054
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Entity Type | Individual
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Provider Name | ROBERT THOMAS B.C.O.
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Gender | Male
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Dates
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Enumeration Date | 01/18/2007
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 1900 KIRBY PKWY STE 102
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City | GERMANTOWN
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State | TN
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Zip | 38138-3653
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Country | US
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Telephone | 901-753-4724
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Fax | 901-759-5920
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Provider Business Mailing Address
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Address Line | 1900 KIRBY PKWY STE 102
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City | GERMANTOWN
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State | TN
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Zip | 38138-3653
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Country | US
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Telephone | 901-753-4724
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Fax | 901-759-5920
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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 | 156FX1700X
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Taxonomy Name | Ocularist
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License Number |
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License Number State |
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