Provider Demographics
NPI:1851618631
Name:MICHELLE THOMAS, OD, PC
Entity Type:Organization
Organization Name:MICHELLE THOMAS, OD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:717-856-2599
Mailing Address - Street 1:730 MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CAMP HILL
Mailing Address - State:PA
Mailing Address - Zip Code:17011-1719
Mailing Address - Country:US
Mailing Address - Phone:717-856-2599
Mailing Address - Fax:
Practice Address - Street 1:730 MEADOW DR
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1719
Practice Address - Country:US
Practice Address - Phone:717-856-2599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-03
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET08738152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1083675599OtherDOCTORS PERSONAL NPI