Individual
CHARLES THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
420 N 2ND ST, AMITE, LA 70422-2420
(985) 748-8750
(985) 748-8795
Mailing address
420 N 2ND ST, AMITE, LA 70422-2420
(985) 748-8750
(985) 748-8795
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
977254T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1351032
—
LA
Enumeration date
03/23/2006
Last updated
10/03/2012
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