Individual
THOMAS JOSEPH BOXBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA712
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100039580A
—
OK
01
—
970016049
RAILROAD MEDICARE
OK
Enumeration date
11/04/2005
Last updated
07/24/2012
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