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Individual

JEREMY D THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1501 N FLORENCE AVE, SUITE 350, CLAREMORE, OK 74017-3179
(918) 343-8574
(918) 343-8575
Mailing address
1501 N FLORENCE, SUITE 350, CLAREMORE, OK 74017-3275
(918) 343-8574
(918) 343-8575

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4495
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11556854
CAQH
05
200197750A
OK
Enumeration date
06/24/2006
Last updated
04/30/2014
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