Provider Demographics
NPI:1962596312
Name:THIMONS, MICHAEL (OD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:THIMONS
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 1:192 WEATHERVANE DR.
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057
Mailing Address - Country:US
Mailing Address - Phone:412-716-6433
Mailing Address - Fax:330-505-3681
Practice Address - Street 1:906 GREAT EAST PLZ
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4818
Practice Address - Country:US
Practice Address - Phone:330-505-1327
Practice Address - Fax:330-505-3681
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000872152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management