Healthcare Provider Details

I. General information

NPI: 1699473066
Provider Name (Legal Business Name): AMY DAWN TOOMBS WILKS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 S PITTSBURG AVE
TULSA OK
74112-1233
US

IV. Provider business mailing address

447 S PITTSBURG AVE
TULSA OK
74112-1233
US

V. Phone/Fax

Practice location:
  • Phone: 918-630-5454
  • Fax:
Mailing address:
  • Phone: 918-630-5454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: