Individual
DR. THOMAS E EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10054 COOLEY RD, BROOKVILLE, IN 47012-9511
(765) 647-6883
(765) 647-6883
Mailing address
10054 COOLEY RD, BROOKVILLE, IN 47012-9511
(765) 647-6883
(765) 647-6883
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001538B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001
VSP
—
01
—
0168170002
DME MEDICARE
IN
05
—
100153310B
—
IN
01
—
5059021
AETNA
—
01
—
IN1538
EYE MED
—
Enumeration date
12/09/2005
Last updated
04/20/2015
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