Individual
THOMAS R TODD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4716 W URBANA ST STE 211, BROKEN ARROW, OK 74012-6157
(187) 104-1129
Mailing address
4716 W URBANA ST, STE 211, BROKEN ARROW, OK 74012-6157
(918) 710-4112
(918) 710-4118
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
20778
OK
207Q00000X
Family Medicine Physician
Primary
20778
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100132190C
—
OK
Enumeration date
06/13/2006
Last updated
10/26/2020
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