Provider Demographics
NPI:1902942386
Name:TOWNSEND, THOMAS E (OD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:TOWNSEND
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 1:715 MORTON STREET
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242
Mailing Address - Country:US
Mailing Address - Phone:731-644-9180
Mailing Address - Fax:731-642-9180
Practice Address - Street 1:715 MORTON STREET
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242
Practice Address - Country:US
Practice Address - Phone:731-644-9180
Practice Address - Fax:731-642-9180
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNODT000582152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN35936281Medicaid
TN0555570001Medicare NSC
TN35936281Medicare PIN
TN35936281Medicaid