Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | 20842 | OK |
NPI | 1366410441 |
---|---|
Provider Name | Dr. Richard D Thomas |
First Address | Tulsa, OK 74146 |
Second Address | Tulsa, OK 74146-5822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2006 |
Last Update Date | 01/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H57924 | (02) | |
P00041734 | RAILROAD MEDICARE (01) | OK |