Provider Demographics
NPI:1821547803
Name:THOMPSON VISION, LLC
Entity Type:Organization
Organization Name:THOMPSON VISION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:757-491-1977
Mailing Address - Street 1:612 HILLTOP WEST SHOPPING CTR
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6139
Mailing Address - Country:US
Mailing Address - Phone:757-491-1977
Mailing Address - Fax:757-491-1136
Practice Address - Street 1:612 HILLTOP WEST SHOPPING CTR
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6139
Practice Address - Country:US
Practice Address - Phone:757-491-1977
Practice Address - Fax:757-491-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-01
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618002515305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization