Provider Demographics
NPI:1124111851
Name:RAMSUE-THOMPSON, JOYCE A (OD)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:A
Last Name:RAMSUE-THOMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052-3409
Mailing Address - Country:US
Mailing Address - Phone:440-240-1655
Mailing Address - Fax:440-240-1663
Practice Address - Street 1:1205 BROADWAY
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052-3409
Practice Address - Country:US
Practice Address - Phone:440-240-1655
Practice Address - Fax:440-233-0194
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3565152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0730301Medicaid
H240130Medicare UPIN
T80589Medicare UPIN