Organization
CLOVIS VISION ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS GREGORY WILLMON O.D. (PARTNER)
(575) 763-5522
Entity
Organization
Contact information
Practice address
1217 PILE ST, CLOVIS, NM 88101-5944
(575) 763-5522
(575) 763-4722
Mailing address
PO BOX 700, CLOVIS, NM 88102-0700
(575) 763-5522
(575) 763-4722
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
291
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM00P428
BCBS
NM
Enumeration date
09/01/2005
Last updated
03/28/2014
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