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NPI Code Detail

MEDICARE: DR. THOMAS ROBERT MALEY O.D.

MEDICARE: DR. THOMAS ROBERT MALEY 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
1152W00000XOptometrist4262T1058OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00020057OTHEROHRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3000000211210OTHEROHANTHEM BC BS
40351310001OTHEROHDMERC REGION B

General Provider Information

NPI Number : 1770532467
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS ROBERT MALEY O.D.
Provider Business Mailing Address
First Line : 6898 ROUNDWOOD CT
Second Line :
City : DUBLIN
State : OH
Zip : 43016-8623
Country : US
Telephone Number : 614-733-0434
Fax Number : 614-451-8642
Provider Business Practice Location Address
First Line : 2250 N BANK DR
Second Line :
City : COLUMBUS
State : OH
Zip : 43220-5420
Country : US
Telephone Number : 614-451-7550
Fax Number : 614-451-8642
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2006
Last Update Date : 04/20/2008

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