Thomas Preston
Individual provider Active NPI Perfusionist · Arcadia, OK
NPI 1063875318 · NPPES record last updated Apr 4, 2016
Key facts
- NPI
- 1063875318
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Perfusionist 242T00000X
- License
- 112 (OK)
- Practice address
- 13181 Waterrock LN
Arcadia, OK 73007-7631 - Phone
- (405) 604-5613
- Fax
- (405) 601-3750
- NPI assigned
- Apr 4, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 112 | OK | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Perfusionist | 242T00000X | 112 | OK | Yes |
Addresses
Primary practice location
13181 Waterrock LN
Arcadia, OK 73007-7631
Mailing address
13181 Waterrock LN
Arcadia, OK 73007-7631
Phone (405) 604-5613
Other providers in Arcadia, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.