Provider Demographics
NPI:1962667592
Name:THOMAS, AMANDA LYN (MD)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:LYN
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4913 W RENO AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-6339
Mailing Address - Country:US
Mailing Address - Phone:405-948-4900
Mailing Address - Fax:405-948-4933
Practice Address - Street 1:309 S ANN ARBOR AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73128-1112
Practice Address - Country:US
Practice Address - Phone:405-948-4900
Practice Address - Fax:405-948-4933
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2024-04-15
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Provider Licenses
StateLicense IDTaxonomies
OK25138207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK25138OtherSTATE