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General NPI Number Information
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NPI Number | 1730526716
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Entity Type | Individual
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Provider Name | TRAVIS LEE THOMPSON O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 10904 SPRING BLUFF WAY
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City | KNOXVILLE
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State | TN
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Zip | 37932-1793
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Country | US
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Telephone | 865-246-1500
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Fax | 865-245-4522
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Provider Business Mailing Address
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Address Line | 10904 SPRING BLUFF WAY
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City | KNOXVILLE
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State | TN
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Zip | 37932-1793
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Country | US
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Telephone | 865-246-1500
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Fax | 865-245-4522
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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 | 0618002234
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3122
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License Number State | TN
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