Provider Demographics
NPI:1790775492
Name:HANKENSON, THOMAS E III (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:HANKENSON
Suffix:III
Gender:M
Credentials:OD
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Mailing Address - Street 1:18741 PONDEROSA DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-8812
Mailing Address - Country:US
Mailing Address - Phone:303-840-4949
Mailing Address - Fax:303-840-0184
Practice Address - Street 1:18741 E PONDEROSA DRIVE
Practice Address - Street 2:SUITE D
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:303-840-4949
Practice Address - Fax:303-840-0184
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
COCO1884152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COU85383Medicare UPIN