Blackman, Thomas Gibson

Blackman, Thomas Gibson is an sole proprietor health care provider with primary practice located at 208 N Spence Ave , Goldsboro NC 27534-4318. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Blackman, Thomas Gibson can be contacted via phone (919) 778-2015.

Contact Information

Primary practice address
208 N Spence Ave Goldsboro NC 27534-4318
Fax: (919) 778-4808
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 561825115 North Carolina

Profile Details

NPI number 1932299963
LBN Legal business name Blackman, Thomas Gibson
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 13th, 2006
Last updated Dec 27th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932299963 NPPES
North Carolina MEDICAID 790907A

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