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Individual

THOMAS J SHOEMAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
122 N MAIN ST, MARYSVILLE, OH 43040-1106
(934) 642-1300
(937) 642-0101
Mailing address
122 N MAIN ST, MARYSVILLE, OH 43040-1106
(934) 642-1300
(937) 642-0101

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
5156
OH
152W00000X
Optometrist
Primary
OH5091
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000218755
ANTHEM BXBS
OH
01
2202585
UNITED HEALTH CARE
OH
05
2262144
OH
01
2557352
AETNA
OH
01
410046890
RAILROAD MEDICARE
OH
Enumeration date
12/01/2006
Last updated
07/01/2014
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