Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 215 | OK |
N | 222Z00000X | Podiatrist | 215 | OK |
Y | 213ES0103X | Foot & Ankle Surgery | 215 | OK |
NPI | 1023122124 |
---|---|
Provider Name | Timothy D Thomas |
First Address | Oklahoma City, OK 73126-8996 |
Second Address | Oklahoma City, OK 73114-1431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 28/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U97147 | (02) | OK |