Provider Demographics
NPI:1669406187
Name:SCHELL, THOMAS JEFFERSON (OD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JEFFERSON
Last Name:SCHELL
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 1:953 E 1420 N
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-8856
Mailing Address - Country:US
Mailing Address - Phone:801-809-5841
Mailing Address - Fax:
Practice Address - Street 1:4314 KEMP BLVD
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76308-3716
Practice Address - Country:US
Practice Address - Phone:940-691-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6242258-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist