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NPI Code Detail

MEDICARE: DR. THOMAS AARON JUDD O.D.

MEDICARE: DR. THOMAS AARON JUDD O.D.
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
1152W00000XOptometristOPC 4141FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00369128OTHERFLRAIL ROAD MEDICARE

General Provider Information

NPI Number : 1487615704
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS AARON JUDD O.D.
Provider Business Mailing Address
First Line : PO BOX 11407
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35246-8575
Country : US
Telephone Number : 239-466-2020
Fax Number :
Provider Business Practice Location Address
First Line : 15640 NEW HAMPSHIRE CT
Second Line :
City : FORT MYERS
State : FL
Zip : 33908-4168
Country : US
Telephone Number : 239-466-3111
Fax Number : 239-466-9499
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2006
Last Update Date : 07/17/2025

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