Maydew Thibault Optometry LLC

NPI #1720132715 in Medicine Lodge, Kansas

Provider Information

NPI Number: 1720132715
Entity Type: Organization
Organization Name: Maydew Thibault Optometry LLC
Primary Specialty: Optometrist
Enumeration Date: Jan 23, 2007
Last Updated: May 7, 2013

Practice Location

Address: 604 N WALNUT
City: Medicine Lodge
State: Kansas
ZIP Code: 67104
Phone: (620) 886-3222

Authorized Official

Name: DR. TROY O MAYDEW, OD
Title: MEMBER MANAGER
Phone: (620) 886-3222

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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