Provider Demographics
NPI:1881023208
Name:THOMAS, JOSHUA TIMOTHY
Entity type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:TIMOTHY
Last Name:THOMAS
Suffix:
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 1:6216 CANYON DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-6416
Mailing Address - Country:US
Mailing Address - Phone:405-848-7197
Mailing Address - Fax:
Practice Address - Street 1:6216 CANYON DR
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-6416
Practice Address - Country:US
Practice Address - Phone:405-848-7197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-06
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst