Individual
DR. TOM L DEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
204 WEST CENTURY AVE, BISMARCK, ND 58503
(701) 255-0186
(701) 255-3975
Mailing address
204 WEST CENTURY AVE, BISMARCK, ND 58503
(701) 255-0186
(701) 255-3975
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
517
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005179
BCBS
ND
05
—
60453
—
ND
01
—
800517
ND VISION
ND
Enumeration date
03/09/2007
Last updated
08/14/2008
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