Provider Demographics
NPI:1801959820
Name:THOMAS, NEIL M (DC)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:M
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 N 129TH EAST AVE
Mailing Address - Street 2:STE 109
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5376
Mailing Address - Country:US
Mailing Address - Phone:918-376-4117
Mailing Address - Fax:918-376-4127
Practice Address - Street 1:9500 N 129TH EAST AVE
Practice Address - Street 2:STE 109
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5376
Practice Address - Country:US
Practice Address - Phone:918-376-4117
Practice Address - Fax:918-376-4127
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2017-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4112111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT41253OtherBLUE CROSS BLUE SHIELD #
MT000004642Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER