MEDICARE: CHAD J THOMPSON OD CHARTERED

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	1526	KS

General Provider Information

NPI Number	:	1689049116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHAD J THOMPSON OD CHARTERED

Provider Business Mailing Address
First Line	:	128 W KANSAS AVE
Second Line	:
City	:	SMITH CENTER
State	:	KS
Zip	:	66967-2013
Country	:	US
Telephone Number	:	785-282-6086
Fax Number	:	785-282-3978

Provider Business Practice Location Address
First Line	:	128 W KANSAS AVE
Second Line	:
City	:	SMITH CENTER
State	:	KS
Zip	:	66967-2013
Country	:	US
Telephone Number	:	785-282-6086
Fax Number	:	785-282-3978

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CHAD J THOMPSON
Credential	:	OD
Telephone Number	:	785-282-6086

Provider Enumeration Date	:	12/09/2015
Last Update Date	:	12/09/2015

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