Todd, Thomas R

Todd, Thomas R is an individual health care provider with primary practice located at 4716 W Urbana St Ste 211 , Broken Arrow OK 74012-6157. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Todd, Thomas R can be contacted via phone (187) 104-1129.

Contact Information

Primary practice address
4716 W Urbana St Ste 211 Broken Arrow OK 74012-6157
Phone: (187) 104-1129
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 20778 Oklahoma
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 20778 Oklahoma

Profile Details

NPI number 1619919487
LBN Legal business name Todd, Thomas R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Oct 26th, 2020 - about 6 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 1619919487 NPPES
Oklahoma MEDICAID 100132190C

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