Provider Demographics
NPI:1588919443
Name:CRUSE, THOMAS ROBERT (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:CRUSE
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 1:55 MADISON ST
Mailing Address - Street 2:SUITE 355
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206-5419
Mailing Address - Country:US
Mailing Address - Phone:303-377-2020
Mailing Address - Fax:
Practice Address - Street 1:55 MADISON ST
Practice Address - Street 2:SUITE 355
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5419
Practice Address - Country:US
Practice Address - Phone:303-377-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2012-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2843152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist