Individual
TOMMY DEAN CAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1101 NW 178TH ST, SUITE B, EDMOND, OK 73012-4281
(405) 285-2161
(405) 726-8277
Mailing address
1101 NW 178TH ST, SUITE B, EDMOND, OK 73012-4281
(405) 285-2161
(405) 726-8277
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
880
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002275A
—
OK
Enumeration date
06/09/2006
Last updated
04/22/2020
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