Provider Demographics
NPI:1891729620
Name:TRUITT &TRUITT OPTOMETRISTS INC
Entity type:Organization
Organization Name:TRUITT &TRUITT OPTOMETRISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRUITT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:937-644-8637
Mailing Address - Street 1:1001 W FIFTH ST
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040
Mailing Address - Country:US
Mailing Address - Phone:937-644-8637
Mailing Address - Fax:937-644-8653
Practice Address - Street 1:1001 W FIFTH ST
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040
Practice Address - Country:US
Practice Address - Phone:937-644-8637
Practice Address - Fax:937-644-8653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0492980Medicaid
OH9292481Medicare PIN
OH0492980Medicaid