Provider Demographics
NPI:1518988971
Name:WESTERFIELD, THOMAS EMERSON (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EMERSON
Last Name:WESTERFIELD
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 1:203 N 5TH ST
Mailing Address - Street 2:P.O. BOX 158
Mailing Address - City:WEST BRANCH
Mailing Address - State:MI
Mailing Address - Zip Code:48661-1005
Mailing Address - Country:US
Mailing Address - Phone:989-345-1623
Mailing Address - Fax:989-345-0950
Practice Address - Street 1:203 N 5TH ST
Practice Address - Street 2:
Practice Address - City:WEST BRANCH
Practice Address - State:MI
Practice Address - Zip Code:48661-1005
Practice Address - Country:US
Practice Address - Phone:989-345-1623
Practice Address - Fax:989-345-0950
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002320152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIT33487Medicare UPIN
MI0F56504Medicare PIN
MI0309420001Medicare NSC