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NPI Code Detail

MEDICARE: MARY GRACE THETFORD-HARVEY

MEDICARE:   MARY GRACE THETFORD-HARVEY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician39482OK
22084P0804XChild & Adolescent Psychiatry Physician39482OK

General Provider Information

NPI Number : 1033861851
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY GRACE THETFORD-HARVEY
Provider Business Mailing Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-660-3130
Fax Number : 918-660-3132
Provider Business Practice Location Address
First Line : 4502 E 41ST ST
Second Line :
City : TULSA
State : OK
Zip : 74135-2536
Country : US
Telephone Number : 918-660-3130
Fax Number : 918-660-3132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2022
Last Update Date : 01/02/2026

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Directions to “ MARY GRACE THETFORD-HARVEY ” Practice Location

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