Organization
TOM SHI CONNALLY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM SHI CONNALLY M.D. (OWNER)
(405) 329-4102
Entity
Organization
Contact information
Practice address
500 EAST ROBINSON, SUITE 2300, NORMAN, OK 73071-6771
(405) 329-4102
(405) 364-3476
Mailing address
PO BOX 1330, NORMAN, OK 73070-1330
(405) 307-6668
(405) 307-6660
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
23363
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200014890A
—
OK
05
—
200014890B
—
OK
01
—
P00072417
MEDICARE RAILROAD
OK
Enumeration date
05/03/2007
Last updated
01/15/2013
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