MEDICARE: ALICIA REED-THOMAS 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
1	152W00000X	Optometrist	18002645B	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	410048542	OTHER	IN	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0730490001	OTHER	IN	DMERC
2	000000080046	OTHER	IN	BLUE CROSS BLUE SHIELD
3	1022881	OTHER	IN	CHAMPUS
4	1490559	OTHER	IN	UMWA
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629071105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA REED-THOMAS O.D.

Provider Business Mailing Address
First Line	:	603 W NATIONAL AVE
Second Line	:	PO BOX 188
City	:	BRAZIL
State	:	IN
Zip	:	47834
Country	:	US
Telephone Number	:	812-443-3937
Fax Number	:	812-443-3937

Provider Business Practice Location Address
First Line	:	603 W NATIONAL AVE
Second Line	:
City	:	BRAZIL
State	:	IN
Zip	:	47834-0188
Country	:	US
Telephone Number	:	812-443-3937
Fax Number	:	812-443-3937

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	10/26/2009

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Directions to “ ALICIA REED-THOMAS O.D.” Practice Location

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