Provider Demographics
NPI:1548252687
Name:LALONDE, THOMAS E (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:LALONDE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 S HURSTBOURNE PKWY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40220-1622
Mailing Address - Country:US
Mailing Address - Phone:502-491-2232
Mailing Address - Fax:502-499-2700
Practice Address - Street 1:2110 S HURSTBOURNE PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1622
Practice Address - Country:US
Practice Address - Phone:502-491-2232
Practice Address - Fax:502-499-2700
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY08430T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0843DTOtherOD LICENSE NUMBER
KY000000350872OtherANTHEM BCBS
KYP00226627OtherRR MEDICARE
KY77008431Medicaid
T54710Medicare UPIN
KY0843DTOtherOD LICENSE NUMBER
KY77008431Medicaid