Provider Demographics
NPI:1255374898
Name:THOMAS, AMY JEAN (OD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:JEAN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1650 N KOLB RD STE 132
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-4946
Mailing Address - Country:US
Mailing Address - Phone:520-886-8800
Mailing Address - Fax:520-886-8800
Practice Address - Street 1:1650 N KOLB RD STE 132
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4946
Practice Address - Country:US
Practice Address - Phone:520-886-8800
Practice Address - Fax:520-886-8800
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1616152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist