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Individual

THOMAS WILLIAM HURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
6 ROAD 7586, BLOOMFIELD, NM 87413-4934
(505) 368-6401
(505) 368-6431
Mailing address
PO BOX 160, SHIPROCK, NM 87420-0160
(505) 368-6401
(505) 368-6431

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
000369
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01071262
CO
05
432401
AZ
05
78126
NM
Enumeration date
11/02/2005
Last updated
02/01/2008
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