Provider Demographics
NPI:1326575663
Name:THOMAS, LINDSEY C (PA-C)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 N INDEPENDENCE AVE STE 150
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-5300
Mailing Address - Country:US
Mailing Address - Phone:405-951-4360
Mailing Address - Fax:
Practice Address - Street 1:4221 S WESTERN AVE STE 2010
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3445
Practice Address - Country:US
Practice Address - Phone:405-644-5120
Practice Address - Fax:405-644-5309
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2699363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2699OtherOKLAHOMA BOARD OF MEDICAL LICENSURE AND SUPERVISION