Provider Demographics
NPI:1831225655
Name:THOMAS L ASHCRAFT MD & ASSOC. INC
Entity type:Organization
Organization Name:THOMAS L ASHCRAFT MD & ASSOC. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:ASHCRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-744-8882
Mailing Address - Street 1:PO BOX 52010
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74152-0010
Mailing Address - Country:US
Mailing Address - Phone:918-744-8882
Mailing Address - Fax:
Practice Address - Street 1:1822 E 15TH ST
Practice Address - Street 2:#C
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4611
Practice Address - Country:US
Practice Address - Phone:918-744-8882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7499207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200095610AMedicaid
900522353Medicare ID - Type Unspecified
C94650Medicare UPIN