Provider Demographics
NPI:1982982187
Name:THOMAS, MELISSA NICHOLE (OD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:NICHOLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:1275 DICK LONAS RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1382
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:5491 CREEKWOOD PARK BLVD
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-1204
Practice Address - Country:US
Practice Address - Phone:800-500-4667
Practice Address - Fax:833-448-2983
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist