Individual
THOMAS MICHAEL FUNK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
30 N EMERSON AVE, GREENWOOD, IN 46143-8895
(317) 881-3937
(317) 887-4008
Mailing address
30 N EMERSON AVE, GREENWOOD, IN 46143-8895
(317) 881-3937
(317) 887-4008
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002077A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000015215
MPLAN
IN
01
—
000000214774
BCBS
IN
01
—
0005444107
AETNA
IN
01
—
154538
COLE VISION
IN
Enumeration date
08/23/2005
Last updated
07/09/2007
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