Individual
DR. TRAVIS LEE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10904 SPRING BLUFF WAY, KNOXVILLE, TN 37932-1793
(865) 246-1500
(865) 245-4522
Mailing address
10904 SPRING BLUFF WAY, KNOXVILLE, TN 37932-1793
(865) 246-1500
(865) 245-4522
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618002234
VA
152W00000X
Optometrist
Primary
3122
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103I415320
MEDICARE PTAN
TN
05
—
Q006781
—
TN
Enumeration date
05/30/2013
Last updated
08/26/2014
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