Provider Demographics
NPI:1346437142
Name:BOONE, THOMAS LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEE
Last Name:BOONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1007 S ROBERSON RD
Mailing Address - Street 2:
Mailing Address - City:ENGLISH
Mailing Address - State:IN
Mailing Address - Zip Code:47118-6733
Mailing Address - Country:US
Mailing Address - Phone:812-734-4604
Mailing Address - Fax:812-944-1561
Practice Address - Street 1:2910 GRANT LINE ROAD
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-2456
Practice Address - Country:US
Practice Address - Phone:812-944-1472
Practice Address - Fax:812-944-1561
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002742A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist