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General NPI Number Information
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NPI Number | 1962596312
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Entity Type | Individual
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Provider Name | MICHAEL THIMONS O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 906 GREAT EAST PLZ
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City | NILES
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State | OH
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Zip | 44446-4818
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Country | US
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Telephone | 330-505-1327
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Fax | 330-505-3681
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Provider Business Mailing Address
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Address Line | 192 WEATHERVANE DR.
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City | SLIPPERY ROCK
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State | PA
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Zip | 16057
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Country | US
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Telephone | 412-716-6433
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Fax | 330-505-3681
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OEG000872
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License Number State | PA
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