Provider Demographics
NPI:1497767578
Name:SMITH, THOMAS J (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:918-488-6653
Mailing Address - Fax:918-488-6098
Practice Address - Street 1:6161 S YALE AVE # LEVELA
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-502-6720
Practice Address - Fax:918-502-6725
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-09-29
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Provider Licenses
StateLicense IDTaxonomies
CO285812080P0207X
CODR00285812080P0207X
OK378812080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01285816Medicaid
CO01285816Medicaid
COCO305449Medicare PIN