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General NPI Number Information
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NPI Number | 1508966805
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Entity Type | Individual
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Provider Name | DR. THOMAS FRANCIS DETERMAN
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 2750 S PACIFIC AVE SUITE D
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City | YUMA
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State | AZ
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Zip | 85365-3555
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Country | US
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Telephone | 928-782-7557
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Fax | 928-783-8445
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Provider Business Mailing Address
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Address Line | 2750 S PACIFIC AVE STE D
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City | YUMA
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State | AZ
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Zip | 85365-3547
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Country | US
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Telephone | 928-782-7557
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Fax | 928-783-8445
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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 | OD 786
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OD 786
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License Number State | AZ
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