Provider Demographics
NPI:1679660591
Name:TRITSCHLER, THOMAS HARRISON (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HARRISON
Last Name:TRITSCHLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:877 RIVER BARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-6251
Mailing Address - Country:US
Mailing Address - Phone:615-896-6196
Mailing Address - Fax:615-895-0000
Practice Address - Street 1:171 HERITAGE PARK DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1573
Practice Address - Country:US
Practice Address - Phone:615-896-2551
Practice Address - Fax:615-895-7787
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2009-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT-1398152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNU20748Medicare UPIN
TN3374517Medicare ID - Type UnspecifiedGROUP PRICING ID