Provider Demographics
NPI:1104870344
Name:TOMA, ALEDA A (MD)
Entity type:Individual
Prefix:MISS
First Name:ALEDA
Middle Name:A
Last Name:TOMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 NW 56TH ST
Mailing Address - Street 2:SUITE D100
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-4550
Mailing Address - Country:US
Mailing Address - Phone:405-942-9200
Mailing Address - Fax:405-942-9204
Practice Address - Street 1:3525 NW 56TH ST
Practice Address - Street 2:SUITE D100
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-4550
Practice Address - Country:US
Practice Address - Phone:405-942-9200
Practice Address - Fax:405-942-9204
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK15340207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100107390AMedicaid
OK100107390AMedicaid