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General NPI Number Information
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NPI Number | 1447351366
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Entity Type | Individual
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Provider Name | LOYD ELLIOTT THAYER MD
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 12/25/2007
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Provider Practice Location Address
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Address Line | 2007 NORTH COMMERCE SUITE 200 ARDMORE OKLAHOMA
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City | ARDMORE
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State | OK
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Zip | 73401
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Country | US
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Telephone | 580-223-7576
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5519
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City | ARDMORE
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State | OK
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Zip | 73403
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Country | US
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Telephone | 580-223-7576
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 14946
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License Number State | OK
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