Provider Demographics
NPI:1285633107
Name:MURRAY, THOMAS STEPHEN (DPM)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STEPHEN
Last Name:MURRAY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2801 PARKLAWN DR
Mailing Address - Street 2:STE 405
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4211
Mailing Address - Country:US
Mailing Address - Phone:405-733-1711
Mailing Address - Fax:405-733-3111
Practice Address - Street 1:2801 PARKLAWN DR
Practice Address - Street 2:STE 405
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4211
Practice Address - Country:US
Practice Address - Phone:405-733-1711
Practice Address - Fax:405-733-3111
Is Sole Proprietor?:No
Enumeration Date:2005-07-21
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK156213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK480009481OtherRR MEDICARE MWC
OK480003280OtherRR MEDICARE ADA
OK242320202Medicare PIN
OK480003280OtherRR MEDICARE ADA
OK200522012Medicare ID - Type Unspecified
OK0796900001Medicare NSC