Healthcare Provider Details

I. General information

NPI: 1912109869
Provider Name (Legal Business Name): TOBY NEAL THOMPSON PHARM. D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 HILLERY RD
COMANCHE OK
73529-1200
US

IV. Provider business mailing address

RR 3 BOX 33
COMANCHE OK
73529-9513
US

V. Phone/Fax

Practice location:
  • Phone: 580-439-8869
  • Fax: 580-439-2357
Mailing address:
  • Phone: 580-439-8270
  • Fax: 580-439-2357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number12914
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number40206
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: