Individual
DR. JUSTIN THANKACHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 S UTICA AVE, TULSA, OK 74104-4090
(918) 579-1000
Mailing address
6224 E 89TH ST, TULSA, OK 74137-3127
(918) 938-2694
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24623
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200201520A
—
OK
Enumeration date
02/13/2007
Last updated
02/16/2026
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