Individual
DR. THOMAS B. LEAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2015 W BROADWAY ST STE 2A, ARDMORE, OK 73401-2560
(580) 226-2202
(580) 307-6790
Mailing address
PO BOX 6036, ARDMORE, OK 73403-1036
(580) 226-2202
(580) 226-3354
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
2708
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110179812
RAILROAD MEDICARE
OK
01
—
731496030
CHAMPUS/TRICARE
OK
01
—
73149603000
HEALTHCHOICE
OK
01
—
731496030002
BCBS OF OK PROVIDER #
OK
Enumeration date
09/27/2006
Last updated
10/21/2021
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