Provider Demographics
NPI:1114931516
Name:FOSTER, THOMAS ALAN (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:FOSTER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:689A HWY 68
Mailing Address - Street 2:
Mailing Address - City:SWEETWATER
Mailing Address - State:TN
Mailing Address - Zip Code:37874
Mailing Address - Country:US
Mailing Address - Phone:423-337-9222
Mailing Address - Fax:423-337-9099
Practice Address - Street 1:689A HWY 68
Practice Address - Street 2:
Practice Address - City:SWEETWATER
Practice Address - State:TN
Practice Address - Zip Code:37874
Practice Address - Country:US
Practice Address - Phone:423-337-9222
Practice Address - Fax:423-337-9099
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1421152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0167822OtherBCBS
TN0167822OtherBCBS
TN410021702Medicare PIN
TN3598717Medicare PIN
TN3155723OtherBLUE CROSS BLUE SHIELD
TN3598718Medicare PIN
TN3598717Medicare PIN