Provider Demographics
NPI:1831611748
Name:CHOPONIS, THOMAS MATTHEW (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MATTHEW
Last Name:CHOPONIS
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 1:2237 ASHMUN ST
Mailing Address - Street 2:
Mailing Address - City:SAULT SAINTE MARIE
Mailing Address - State:MI
Mailing Address - Zip Code:49783-3704
Mailing Address - Country:US
Mailing Address - Phone:989-944-1560
Mailing Address - Fax:
Practice Address - Street 1:128 W SPRUCE ST STE 1
Practice Address - Street 2:
Practice Address - City:SAULT SAINTE MARIE
Practice Address - State:MI
Practice Address - Zip Code:49783
Practice Address - Country:US
Practice Address - Phone:906-635-9600
Practice Address - Fax:906-635-1077
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005074152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty