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:
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Health care specialties

SpecialtyCodeLicense #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 9 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 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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