Provider Demographics
NPI:1366467573
Name:CRAWFORD, THOMAS S (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:S
Last Name:CRAWFORD
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:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:MILBRIDGE
Mailing Address - State:ME
Mailing Address - Zip Code:04658-0069
Mailing Address - Country:US
Mailing Address - Phone:207-546-7387
Mailing Address - Fax:
Practice Address - Street 1:3 HIGH ST.
Practice Address - Street 2:
Practice Address - City:MILBRIDGE
Practice Address - State:ME
Practice Address - Zip Code:04658
Practice Address - Country:US
Practice Address - Phone:207-546-2357
Practice Address - Fax:207-546-7484
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOPT748152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMC1188324OtherDEA #
MEMC1188324OtherDEA #