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Individual

THOMAS A ROBERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
3458 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3011
(615) 453-5155
(615) 444-5915
Mailing address
3548 N MOUNT JULIET RD, MOUNT JULIET, TN 37122-3061
(615) 754-4733
(615) 758-7515

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODT633
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000017678
BCBS MEDICARE ADVANTAGE
TN
01
1238610001
DMERC
TN
05
3593913
TN
01
410045577
PALMETTO-GBA
TN
01
4406651
AETNA US HEALTHCARE
TN
01
621298175
DEFAULT
TN
01
903833
BLOCK VISION
TN
Enumeration date
07/18/2005
Last updated
07/11/2014
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