Clark, Thomas Eugene
Clark, Thomas Eugene is an individual health care provider with primary practice located at 1715 S Broadway St , New Ulm MN 56073-3751. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Clark, Thomas Eugene can be contacted via phone (507) 354-8531.Contact Information
Primary practice address
1715 S Broadway St
New Ulm MN 56073-3751
Phone: (507) 354-8531
Fax: (507) 359-1124
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2902 | Minnesota |
Profile Details
| NPI number | 1427044692 |
|---|---|
| LBN Legal business name | Clark, Thomas Eugene |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 23rd, 2005 |
| Last updated | Feb 27th, 2015 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1427044692 | NPPES |
| Minnesota | Other | 241M0CL | BLUE CROSS/BLUE SHIELD MN |
| Minnesota | Other | 1034694 | BLUE CROSS/BLUE SHIELD MN |
| Minnesota | Other | 2202087 | BLUE CROSS/BLUE SHIELD MN |
| Minnesota | MEDICAID | 747652300 | BLUE CROSS/BLUE SHIELD MN |
| Minnesota | Other | HP38790 | BLUE CROSS/BLUE SHIELD MN |
| Minnesota | Other | 171829 | BLUE CROSS/BLUE SHIELD MN |
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