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General NPI Number Information
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NPI Number | 1386850923
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Entity Type | Organization
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Legal Business Name | THOMAS FLICKINGER OD PHD LLC
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 03/18/2011
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Provider Practice Location Address
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Address Line | 3040 W MARKET ST
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City | FAIRLAWN
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State | OH
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Zip | 44333-3642
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Country | US
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Telephone | 330-836-3828
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Fax | 330-836-3727
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Provider Business Mailing Address
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Address Line | 3040 W MARKET ST
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City | FAIRLAWN
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State | OH
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Zip | 44333-3642
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Country | US
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Telephone | 330-836-3828
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Fax | 330-836-3727
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS FLICKINGER
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Credential | O.D., PH.D.
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Telephone | 330-836-3828
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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 | OH4983
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License Number State | OH
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