Hall, Tom Lavern
Hall, Tom Lavern is an individual health care provider with primary practice located at 136 E Grand River Ave , Fowlerville MI 48836. He recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Pediatrics, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Hall, Tom Lavern can be contacted via phone (517) 223-9988.Contact Information
Primary practice address
136 E Grand River Ave
Fowlerville MI 48836
Phone: (517) 223-9988
Fax: (517) 223-9071
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 4901004859 | Michigan |
| Eye and Vision Services Providers / Pediatrics | 152WP0200X | 4901004859 | Michigan |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004859 | Michigan |
Profile Details
| NPI number | 1336556893 |
|---|---|
| LBN Legal business name | Hall, Tom Lavern |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 16th, 2014 |
| Last updated | Oct 8th, 2018 - about 6 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 | 1336556893 | NPPES |
| Michigan | MEDICAID | 1336556893 |
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