Provider Demographics
NPI:1639460603
Name:THOMASON, TREY D (DO)
Entity Type:Individual
Prefix:DR
First Name:TREY
Middle Name:D
Last Name:THOMASON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 E LUELLEN RD
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73047-9524
Mailing Address - Country:US
Mailing Address - Phone:405-542-2278
Mailing Address - Fax:405-542-2281
Practice Address - Street 1:112 E LUELLEN RD
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:OK
Practice Address - Zip Code:73047-9524
Practice Address - Country:US
Practice Address - Phone:405-542-2278
Practice Address - Fax:405-542-2281
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5830207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics