Roth, Thomas Barker

Roth, Thomas Barker is an individual health care provider with primary practice located at 2500 Packard Rd Ste #103, Ann Arbor MI 48104-6827. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Roth, Thomas Barker can be contacted via phone (734) 973-1990.

Contact Information

Primary practice address
2500 Packard Rd Ste #103 Ann Arbor MI 48104-6827
Phone: (734) 973-1990
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901002292 Michigan

Profile Details

NPI number 1346380185
LBN Legal business name Roth, Thomas Barker
Credentials OPTOMETRIST OD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2007
Last updated Jul 8th, 2007 - about 19 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 1346380185 NPPES
Michigan Other 90OH165310 BLUE CROSS BLUE SHIELD MI
Michigan MEDICAID 5011007 BLUE CROSS BLUE SHIELD MI
Michigan Other VLM0045 BLUE CROSS BLUE SHIELD MI
Michigan Other 54OH10378 BLUE CROSS BLUE SHIELD MI

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