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NPI Code Detail

MEDICARE: DR. THOMAS LEE COURY D.M.D.

MEDICARE: DR. THOMAS LEE COURY D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist3611OK

General Provider Information

NPI Number : 1023225216
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS LEE COURY D.M.D.
Provider Business Mailing Address
First Line : 4122 N.W. 62ND STREET
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-1351
Country : US
Telephone Number : 405-947-5329
Fax Number :
Provider Business Practice Location Address
First Line : 4122 NW 62ND ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-1351
Country : US
Telephone Number : 405-947-5329
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2007
Last Update Date : 07/08/2007

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