Basic Information
| Provider Information | |||||||||
| NPI: | 1538153382 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THORPE | ||||||||
| FirstName: | RODNEY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3461 TOWNE BLVD | ||||||||
| Address2: | SUITE B-200 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450055536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134245217 | ||||||||
| FaxNumber: | 5134240205 | ||||||||
| Practice Location | |||||||||
| Address1: | 3461 TOWNE BLVD | ||||||||
| Address2: | SUITE B-200 | ||||||||
| City: | FRANKLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 450055536 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134245217 | ||||||||
| FaxNumber: | 5134240205 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/08/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2552 | OH | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 0037384 | 05 | OH | MEDICAID |