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NPI Code Detail

MEDICARE: DR. THOMAS B BRUMLEY

MEDICARE: DR. THOMAS B BRUMLEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist35-03-0075OH
2156FX1100XOphthalmic Technician/Technologist35-03-0075OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205839453
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS B BRUMLEY
Provider Business Mailing Address
First Line : 3509 BRIARFIELD BLVD
Second Line :
City : MAUMEE
State : OH
Zip : 43537-9383
Country : US
Telephone Number : 419-865-3866
Fax Number : 419-865-3866
Provider Business Practice Location Address
First Line : 3509 BRIARFIELD BLVD
Second Line :
City : MAUMEE
State : OH
Zip : 43537-9383
Country : US
Telephone Number : 419-865-3866
Fax Number : 419-865-3451
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 09/13/2012

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