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Organization

THOMAS OPTICAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILLIP SHANE THOMAS (OWNER/OPTICIAN)
(812) 503-5181
Entity
Organization

Contact information

Practice address
954 MARKET ST, CHARLESTOWN, IN 47111-1951
(812) 503-5181
(812) 565-2801
Mailing address
954 MARKET ST, CHARLESTOWN, IN 47111-1951
(812) 503-5181
(812) 565-2801

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
156FX1800X
Optician
332H00000X
Eyewear Supplier
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1346664745
IN
Enumeration date
06/07/2017
Last updated
06/07/2017
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