Thames, Dalton Blake

Thames, Dalton Blake is an individual health care provider with primary practice located at 1200 E Pecan St , Altus OK 73521-6141. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Thames, Dalton Blake can be contacted via phone (580) 379-5000.

Contact Information

Primary practice address
1200 E Pecan St Altus OK 73521-6141
Phone: (580) 379-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 128248 Oklahoma

Profile Details

NPI number 1740797695
LBN Legal business name Thames, Dalton Blake
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 1st, 2018
Last updated Aug 17th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740797695 NPPES
Oklahoma MEDICAID 200747670A

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