Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | F0996 | TX |
N | 207XS0106X | Orthopaedic Hand Surgeon | 2243 | OK |
N | 207XS0106X | Orthopaedic Hand Surgeon | 5101007044 | MI |
N | 207XS0106X | Orthopaedic Hand Surgeon | F0996 | TX |
NPI | 1326086505 |
---|---|
Provider Name | Dr. Tom Wallace Ewing |
First Address | Norman, OK 73069-6341 |
Second Address | Norman, OK 73069-6341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 02/01/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100228970D | (05) | OK |
B76197 | (02) | OK |