Provider Demographics
NPI:1841075546
Name:BURKHAMMER, TOMMY SR
Entity type:Individual
Prefix:MR
First Name:TOMMY
Middle Name:
Last Name:BURKHAMMER
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 SEMINARY AVE
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-6917
Mailing Address - Country:US
Mailing Address - Phone:918-315-3838
Mailing Address - Fax:
Practice Address - Street 1:920 SEMINARY AVE
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-6917
Practice Address - Country:US
Practice Address - Phone:918-315-3838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist