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General NPI Number Information
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NPI Number | 1275162356
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Entity Type | Individual
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Provider Name | THOMAS JAMES DEWEY
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Gender | Male
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 14002 E 21ST ST STE 1130
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City | TULSA
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State | OK
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Zip | 74134-1408
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Country | US
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Telephone | 918-439-1500
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Fax | 918-439-1199
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Provider Business Mailing Address
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Address Line | 141 S COLEMAN ST
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City | TOOELE
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State | UT
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Zip | 84074-2048
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Country | US
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Telephone | 801-690-9585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7499
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License Number State | OK
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