Provider Demographics
NPI:1548222375
Name:THOMAS, DAVID BEYNON III (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BEYNON
Last Name:THOMAS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:6234 E 99TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-5503
Mailing Address - Country:US
Mailing Address - Phone:918-299-1707
Mailing Address - Fax:918-299-7291
Practice Address - Street 1:6161 S YALE AVE
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:918-494-8467
Practice Address - Fax:918-494-8448
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
OK11255208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD42878Medicare UPIN