Thomas C. Church M.D., PA

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME0016848 Issued in FL

Legal business name

THOMAS C. CHURCH M.D., PA

Practice address

51 Yacht Club Dr NE
Fort Walton Beach, FL 32548-4473

Phone

(850) 244-1157

NPI assigned

Jul 22, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas Church

Title

Director

Phone

(850) 244-1157

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1114948387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 YACHT CLUB DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484473",
            "telephone_number": "850-244-1157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 YACHT CLUB DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325484473",
            "telephone_number": "850-244-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS C. CHURCH M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "850-244-1157"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME0016848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ophthalmology Physician in Fort Walton Beach, FL
• Providers in Fort Walton Beach, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.