Individual
MR. ROBERT THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.C.O.
Contact information
Practice address
1900 KIRBY PKWY STE 102, GERMANTOWN, TN 38138-3653
(901) 753-4724
(901) 759-5920
Mailing address
1900 KIRBY PKWY STE 102, GERMANTOWN, TN 38138-3653
(901) 753-4724
(901) 759-5920
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0165655
BLUE CROSS BLUE SHIELD
TN
05
—
3554760
—
TN
Enumeration date
01/18/2007
Last updated
02/19/2008
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