# MR. GORDON THOMAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386690048
- **Gender:** Man
- **Credential:** OD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | OP0002130 | FL | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 06/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001656500 | MEDICAID INDIVIDUAL | FL |
| 01 | — | 1386690048 | MEDICARE NPI | FL |
| 01 | — | 1518098102 | MEDICARE GROUP NPI | FL |
| 01 | — | 19050 | BCBS INDIVIDUAL | — |
| 01 | — | 19050X | MEDICARE PTAN | FL |
| 01 | — | 33801 | BCBS GROUP | — |
| 01 | — | 620437600 | MEDICAID GROUP | FL |
| 01 | — | ECPA-EYE MED | FL2130 | — |