Provider Demographics
NPI:1588628143
Name:HOBBS, THOMAS W (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:HOBBS
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 1:13 NE 550TH RD
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-7473
Mailing Address - Country:US
Mailing Address - Phone:660-864-4576
Mailing Address - Fax:
Practice Address - Street 1:1400 S LIMIT AVE STE 75
Practice Address - Street 2:
Practice Address - City:SEDALIA
Practice Address - State:MO
Practice Address - Zip Code:65301-5116
Practice Address - Country:US
Practice Address - Phone:660-827-3140
Practice Address - Fax:660-827-5204
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO3041152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
04580012OtherBLUE CROSS BLUE SHIELD KC 8 DIGIT BILLING NUMBER
MO316672641Medicaid
MO316672625Medicaid
22409010OtherBLUE CROSS BLUE SHIELD KC
G494618BMedicare PIN
410030338Medicare PIN
0710770002Medicare NSC
410033890Medicare PIN
U43216Medicare UPIN
22409010OtherBLUE CROSS BLUE SHIELD KC
MO316672641Medicaid