Provider Demographics
NPI:1285738468
Name:WESTBROOK, TOIKUS Z (MD)
Entity type:Individual
Prefix:DR
First Name:TOIKUS
Middle Name:Z
Last Name:WESTBROOK
Suffix:
Gender:M
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:DEPT 960295
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73196-0295
Mailing Address - Country:US
Mailing Address - Phone:877-485-4474
Mailing Address - Fax:
Practice Address - Street 1:886 HIGHWAY 411 N
Practice Address - Street 2:
Practice Address - City:ETOWAH
Practice Address - State:TN
Practice Address - Zip Code:37331-1912
Practice Address - Country:US
Practice Address - Phone:423-263-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18751207Q00000X
TN40697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP01116008OtherRAILROAD MCARE
MS07655571Medicaid
TN1506779Medicaid
TN103I081471Medicare PIN
MSI44494Medicare UPIN
MS07655571Medicaid