Organization
ANGELA M THOMAS, O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA M THOMAS OD (OWNER)
(662) 289-1067
Entity
Organization
Contact information
Practice address
59 VETERANS MEMORIAL DR, KOSCIUSKO, MS 39090-3433
(662) 289-1067
(662) 289-1058
Mailing address
PO BOX 778, KOSCIUSKO, MS 39090-0778
(662) 289-1067
(662) 289-1058
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
562
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00087013
—
MS
01
—
P00065350
RAIL ROAD MEDICARE-
MS
Enumeration date
08/24/2007
Last updated
06/09/2008
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