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General NPI Number Information
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NPI Number | 1669626263
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Entity Type | Organization
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Legal Business Name | ARTHRITIS CARE CENTER OKLAHOMA PLLC
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Dates
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Enumeration Date | 11/10/2008
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Last Update Date | 05/02/2014
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Provider Practice Location Address
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Address Line | 2401 N COMMERCE ST C
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City | ARDMORE
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State | OK
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Zip | 73401-1311
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Country | US
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Telephone | 580-226-2202
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Fax | 580-226-3354
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Provider Business Mailing Address
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Address Line | PO BOX 6036
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City | ARDMORE
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State | OK
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Zip | 73403-1036
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Country | US
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Telephone | 580-226-2202
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Fax | 580-226-3354
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS BARTON LEAHEY
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Credential | D.O.
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Telephone | 580-226-2202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2708
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License Number State | OK
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