Active NPI
Thomas Alan Dafforn, PHD
- Psychologist
- Tulsa, OK
National Provider Identifier
1235341389
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 613
- Practice address
- 4870 S Lewis Avenue
Suite 180
Tulsa, OK 74105-5141 - Phone
- (918) 477-2649
- Fax
- (918) 524-1480
- NPI assigned
- May 3, 2007
- Last updated
- Jan 28, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 613 | OK | Primary |
Addresses
Primary practice location
4870 S Lewis Avenue
Suite 180
Tulsa, OK 74105-5141
Mailing address
4870 S Lewis Avenue
Suite 180
Tulsa, OK 74105-5141
Phone (918) 477-2649
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 613 | OK | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390867200000",
"number": "1235341389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4870 S LEWIS AVENUE",
"address_2": "SUITE 180",
"city": "TULSA",
"state": "OK",
"postal_code": "741055141",
"telephone_number": "918-477-2649",
"fax_number": "918-524-1480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4870 S LEWIS AVENUE",
"address_2": "SUITE 180",
"city": "TULSA",
"state": "OK",
"postal_code": "741055141",
"telephone_number": "918-477-2649",
"fax_number": "918-524-1480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAFFORN",
"first_name": "THOMAS",
"middle_name": "ALAN",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2014-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "OK",
"license": "613",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.