Provider Demographics
NPI:1760561054
Name:DR WILLIAM B THOMAS OPTOMETRIST INC.
Entity Type:Organization
Organization Name:DR WILLIAM B THOMAS OPTOMETRIST INC.
Other - Org Name:DR ROBERT D THOMAS AND DR WILLIAM B THOMAS OPTOMETRISTS INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:740-446-0152
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:GALLIPOLIS
Mailing Address - State:OH
Mailing Address - Zip Code:45631-0152
Mailing Address - Country:US
Mailing Address - Phone:740-446-0152
Mailing Address - Fax:740-446-0450
Practice Address - Street 1:346 THIRD AVENUE
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-0152
Practice Address - Country:US
Practice Address - Phone:740-446-0152
Practice Address - Fax:740-446-0450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2842T1607152W00000X
WV577152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0808110001Medicare NSC