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NPI Code Detail

MEDICARE: DR. THOMAS JOHN PALMER D.O.

MEDICARE: DR. THOMAS JOHN PALMER D.O.
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
1207R00000XInternal Medicine Physician5048OK
2208M00000XHospitalist Physician5048OK

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
22V3017OTHEROKMEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1699074468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JOHN PALMER D.O.
Provider Business Mailing Address
First Line : 5310 E 31ST ST STE 13
Second Line :
City : TULSA
State : OK
Zip : 74135-5013
Country : US
Telephone Number : 918-561-5701
Fax Number : 918-561-1173
Provider Business Practice Location Address
First Line : 744 W 9TH ST
Second Line :
City : TULSA
State : OK
Zip : 74127-9907
Country : US
Telephone Number : 918-382-5064
Fax Number : 918-382-3589
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2011
Last Update Date : 09/11/2024

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