Provider Demographics
NPI:1578794509
Name:THOMASON EYE CARE, P.A.
Entity Type:Organization
Organization Name:THOMASON EYE CARE, P.A.
Other - Org Name:ADVANCED FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICAH
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:THOMASON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:479-750-3937
Mailing Address - Street 1:1127 S GUTENSOHN RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72762-5228
Mailing Address - Country:US
Mailing Address - Phone:479-750-3937
Mailing Address - Fax:479-750-3943
Practice Address - Street 1:1127 S GUTENSOHN RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SPRINGDALE
Practice Address - State:AR
Practice Address - Zip Code:72762-5228
Practice Address - Country:US
Practice Address - Phone:479-750-3937
Practice Address - Fax:479-750-3943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-08
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2634152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR6263900001Medicare NSC