Provider Demographics
NPI:1477506798
Name:TUFARO, ANTHONY (MD, DDS)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:TUFARO
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 STANTON L YOUNG BLVD STE 8300
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5018
Mailing Address - Country:US
Mailing Address - Phone:405-271-2220
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE # A60
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-5417
Practice Address - Country:US
Practice Address - Phone:216-444-2501
Practice Address - Fax:216-444-9419
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD53606208200000X, 208200000X
OH35.142873208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD556100100Medicaid
MD556100100Medicaid
MDG88487Medicare UPIN