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General NPI Number Information
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NPI Number | 1740596030
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Entity Type | Individual
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Provider Name | JOSHUA BRANDON THOMAS ARNP
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Gender | Male
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Dates
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Enumeration Date | 08/24/2010
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Last Update Date | 08/24/2010
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Provider Practice Location Address
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Address Line | 1705 E 19TH ST SUITE 302
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City | TULSA
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State | OK
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Zip | 74104-5405
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Country | US
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Telephone | 918-748-7585
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Fax | 918-748-7539
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Provider Business Mailing Address
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Address Line | 1515 N HARVARD AVE SUITE E
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City | TULSA
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State | OK
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Zip | 74115-4957
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Country | US
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Telephone | 918-832-6049
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Fax | 918-832-6055
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 84812
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License Number State | OK
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