Provider Demographics
NPI:1003911777
Name:ROSE FOOT AND ANKLE, P.C.
Entity Type:Organization
Organization Name:ROSE FOOT AND ANKLE, P.C.
Other - Org Name:THOMAS S. MURRAY, DPM, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JODY
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:ROSE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:405-733-1711
Mailing Address - Street 1:4400 GRANT BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-0038
Mailing Address - Country:US
Mailing Address - Phone:405-733-1711
Mailing Address - Fax:405-733-3111
Practice Address - Street 1:4400 GRANT BLVD STE 110
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0038
Practice Address - Country:US
Practice Address - Phone:405-733-1711
Practice Address - Fax:405-733-3111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatricGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK480009481OtherRAILROAD MEDICARE
OK480009481OtherRAILROAD MEDICARE
OK480003280OtherRR MEDICARE ADA
OK200522012Medicare ID - Type UnspecifiedCURRENT GROUP NUMBER
OK0796900001Medicare NSC