Provider Demographics
NPI:1114943222
Name:OKNER, THOMAS LUKE (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LUKE
Last Name:OKNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9087 BREAKWATER DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34120-4218
Mailing Address - Country:US
Mailing Address - Phone:612-325-4547
Mailing Address - Fax:
Practice Address - Street 1:9087 BREAKWATER DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34120-4218
Practice Address - Country:US
Practice Address - Phone:612-325-4547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME121668207Y00000X
MN28294208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN303868800Medicaid
MN303868800Medicaid
A95604Medicare UPIN