National Provider Identifier Database

THOMAS G PETERSON, OD – NPI #1114043387
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

THOMAS G PETERSON, OD
150A COUNTY ROAD B
SHAWANO, WI54166
Phone: 715-526-3163
Fax: 715-526-4019
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for THOMAS G PETERSON

NPI Number 1114043387
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 03/21/2007
Last updated 07/22/2018 - About 8 years ago
Sole proprietor1 No
Identifiers
  • WI License #: 2324
  • WI Medicaid: 38578000
  • WI Other: 410033786 RAILROAD MEDICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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