Whalio Doctors

NPI 1003874991

Robert Mitchell Thacker, OD

Practitioner Optometrist Providence, RI

Practice location

Address
1466 Broad St, Providence, RI 02905-2836
Phone
(401) 941-6221
Fax
(401) 941-6227
Mailing address
506 Fish Hill Rd, West Greenwich, RI 02817-2209

Registered specialties

Optometrist Primary
Eye and Vision Services Providers Taxonomy 152W00000X Licence ODTA00456 (RI)

Registry record

NPI
1003874991
Entity type
Individual
Sex (as registered)
Male
NPI issued
2 May 2006
Record last updated
19 Sep 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.