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General NPI Number Information
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NPI Number | 1750380085
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Entity Type | Individual
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Provider Name | THOMAS W. RICKNER MD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2005
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Last Update Date | 10/03/2012
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Provider Practice Location Address
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Address Line | 6585 S YALE AVE SUITE 720
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City | TULSA
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State | OK
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Zip | 74136-8384
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Country | US
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Telephone | 918-502-5930
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Fax | 918-502-5935
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Provider Business Mailing Address
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Address Line | 6600 S. YALE SUITE 1400
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City | TULSA
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State | OK
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Zip | 74136
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Country | US
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Telephone | 918-488-6001
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 23733
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License Number State | OK
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