Provider Demographics
NPI:1538361159
Name:WOHL, THOMAS A (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:WOHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5890 MAYFAIR RD
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-1547
Mailing Address - Country:US
Mailing Address - Phone:330-305-2200
Mailing Address - Fax:615-591-1685
Practice Address - Street 1:5890 MAYFAIR RD
Practice Address - Street 2:
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-1547
Practice Address - Country:US
Practice Address - Phone:330-305-2200
Practice Address - Fax:330-305-2210
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35132358207W00000X
CT052485207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNF36880Medicare UPIN
TN3819109Medicare ID - Type Unspecified