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Organization

MAYDEW THIBAULT OPTOMETRY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TROY O MAYDEW OD (MANAGING MEMBER)
(620) 672-5934
Entity
Organization

Contact information

Practice address
216 S OAK ST, PRATT, KS 67124-2721
(620) 672-5934
(620) 672-3550
Mailing address
PO BOX 1024, 216 S. OAK ST., PRATT, KS 67124-1024
(620) 672-5934
(620) 672-3550

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200966630A
KS
Enumeration date
12/18/2006
Last updated
05/07/2013
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