Provider Demographics
NPI:1932978590
Name:FLEMING, TIA R
Entity Type:Individual
Prefix:
First Name:TIA
Middle Name:R
Last Name:FLEMING
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:TIA
Other - Middle Name:R
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3635 S INDIANAPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2229
Mailing Address - Country:US
Mailing Address - Phone:202-297-9374
Mailing Address - Fax:
Practice Address - Street 1:3635 S INDIANAPOLIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2229
Practice Address - Country:US
Practice Address - Phone:202-297-9374
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-25
Last Update Date:2023-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist