Provider Demographics
NPI:1760165062
Name:TUBBS, LAYTON ANTHONY (PT)
Entity Type:Individual
Prefix:
First Name:LAYTON
Middle Name:ANTHONY
Last Name:TUBBS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3004 W UNIVERSITY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2999
Mailing Address - Country:US
Mailing Address - Phone:580-920-2231
Mailing Address - Fax:580-920-2242
Practice Address - Street 1:3004 W UNIVERSITY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2999
Practice Address - Country:US
Practice Address - Phone:580-920-2231
Practice Address - Fax:580-920-2242
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT6430208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation