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NPI Code Detail

MEDICARE: MR. THOMAS RAY THOMSON M.ED.

MEDICARE:  MR. THOMAS RAY THOMSON  M.ED.
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
1101YM0800XMental Health Counselor2968OK

General Provider Information

NPI Number : 1033140520
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. THOMAS RAY THOMSON M.ED.
Provider Business Mailing Address
First Line : 2212 NW 50TH ST
Second Line : SUITE 241 C
City : OKLAHOMA CITY
State : OK
Zip : 73112-8086
Country : US
Telephone Number : 405-408-5760
Fax Number : 405-418-0324
Provider Business Practice Location Address
First Line : 2212 NW 50TH ST
Second Line : SUITE 241 C
City : OKLAHOMA CITY
State : OK
Zip : 73112-8086
Country : US
Telephone Number : 405-408-5760
Fax Number : 405-418-0324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2006
Last Update Date : 07/08/2007

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Directions to “ MR. THOMAS RAY THOMSON M.ED.” Practice Location

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