Healthcare Provider Details

I. General information

NPI: 1326575663
Provider Name (Legal Business Name): LINDSEY C THOMAS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 05/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4221 S WESTERN AVE STE 2010
OKLAHOMA CITY OK
73109-3445
US

IV. Provider business mailing address

5400 N INDEPENDENCE AVE STE 150
OKLAHOMA CITY OK
73112-5300
US

V. Phone/Fax

Practice location:
  • Phone: 405-644-5120
  • Fax: 405-644-5309
Mailing address:
  • Phone: 405-951-4360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number2699
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: