MEDICARE: DR. THOMAS W MEAKER

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	000157	VT

General Provider Information

NPI Number	:	1841298080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS W MEAKER

Provider Business Mailing Address
First Line	:	31 N MAIN ST
Second Line	:
City	:	WATERBURY
State	:	VT
Zip	:	05676-1835
Country	:	US
Telephone Number	:	802-244-1360
Fax Number	:	802-244-1399

Provider Business Practice Location Address
First Line	:	31 N MAIN ST
Second Line	:
City	:	WATERBURY
State	:	VT
Zip	:	05676-1835
Country	:	US
Telephone Number	:	802-244-1360
Fax Number	:	802-244-1399

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

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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