Provider Demographics
NPI:1467446518
Name:THOMAS-PINKSTON, JULIE D (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:D
Last Name:THOMAS-PINKSTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:DIANNE
Other - Last Name:PINKSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 26901
Mailing Address - Street 2:WP1140
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126
Mailing Address - Country:US
Mailing Address - Phone:405-271-4351
Mailing Address - Fax:405-271-8695
Practice Address - Street 1:920 STANTON L YOUNG BLVD # WP1140
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5036
Practice Address - Country:US
Practice Address - Phone:405-271-4351
Practice Address - Fax:405-271-8695
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2907207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK050062775OtherRR MEDICARE
OK141624800OtherDOL
OK5622461OtherAETNA
OK100102380BMedicaid
OK100102380BMedicaid
OK$$$$$$$$$Medicare PIN
OK141624800OtherDOL