Provider Demographics
NPI:1568516110
Name:THOMAS, MORTON DAVID (OD)
Entity Type:Individual
Prefix:DR
First Name:MORTON
Middle Name:DAVID
Last Name:THOMAS
Suffix:
Gender:M
Credentials:OD
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Mailing Address - Street 1:6347 SHADOW RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5647
Mailing Address - Country:US
Mailing Address - Phone:615-309-9928
Mailing Address - Fax:615-771-7285
Practice Address - Street 1:443 COOL SPRINGS BLVD
Practice Address - Street 2:SUITE 120
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-4629
Practice Address - Country:US
Practice Address - Phone:615-771-7205
Practice Address - Fax:615-771-7285
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2010-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNODT877152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU16746Medicare UPIN