Provider Demographics
NPI:1871780536
Name:THOMPSON FAMILY EYECARE, INC
Entity type:Organization
Organization Name:THOMPSON FAMILY EYECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOD
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:317-838-0202
Mailing Address - Street 1:1620 HAWTHORNE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-1894
Mailing Address - Country:US
Mailing Address - Phone:317-838-0202
Mailing Address - Fax:317-838-0027
Practice Address - Street 1:1620 HAWTHORNE DR
Practice Address - Street 2:SUITE 300
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-1894
Practice Address - Country:US
Practice Address - Phone:317-838-0202
Practice Address - Fax:317-838-0027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002218332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN796880Medicare PIN
IN5846540001Medicare NSC