Dr. Robert Mitchell Thacker
Optometrist
1466 Broad St
Providence
, Rhode Island 02905-2836
Dr. Robert Mitchell Thacker
Optometrist
1466 Broad St
Providence
, Rhode Island 02905-2836
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About
Features
Specialties
- Optometrist
Languages spoken
- English
Location
First Address
- Dr. Robert Mitchell Thacker
- 506 Fish Hill Rd
- West Greenwich, RI
- Zip : 02817-2209
- Phone :
Second Address
- Dr. Robert Mitchell Thacker
- 1466 Broad St
- Providence, RI
- Zip : 02905-2836
- Fax : (401) 941-6227
- Phone : (401) 941-6221
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 152W00000X | Optometrist | ODTA00456 | RI |
National Provider Identifier
| NPI | 1003874991 |
|---|---|
| Provider Name | Dr. Robert Mitchell Thacker |
| First Address | West Greenwich, RI 02817-2209 |
| Second Address | Providence, RI 02905-2836 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/05/2006 |
| Last Update Date | 19/09/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U55347 | (02) | RI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.