MEDICARE: THOMAS BOXLEY

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1366802324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS BOXLEY

Provider Business Mailing Address
First Line	:	PO BOX 481212
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74148-1212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2222 W NEWTON ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74127-3016
Country	:	US
Telephone Number	:	918-809-2783
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2016
Last Update Date	:	03/03/2016

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Directions to “ THOMAS BOXLEY ” Practice Location

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