Provider Demographics
NPI:1821039595
Name:ROBBINS, THOMPSON N (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMPSON
Middle Name:N
Last Name:ROBBINS
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 1:610 W 38TH ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46953-4864
Mailing Address - Country:US
Mailing Address - Phone:765-674-7525
Mailing Address - Fax:765-674-7844
Practice Address - Street 1:610 W 38TH ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46953-4864
Practice Address - Country:US
Practice Address - Phone:765-674-7525
Practice Address - Fax:765-674-7844
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001388152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN352021416OtherFEDERAL TAX ID NUMBER
IN296560Medicare PIN
IN352021416OtherFEDERAL TAX ID NUMBER
INT35153Medicare UPIN