Provider Demographics
NPI:1366413825
Name:CONIGLIONE, THOMAS C (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:CONIGLIONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:14024 QUAIL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1006
Mailing Address - Country:US
Mailing Address - Phone:405-419-8447
Mailing Address - Fax:405-419-7745
Practice Address - Street 1:9800 BROADWAY EXT
Practice Address - Street 2:SUITE 201
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-6303
Practice Address - Country:US
Practice Address - Phone:405-419-5440
Practice Address - Fax:405-419-5465
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2016-05-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK9775207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK110205634OtherRAILROAD MEDICARE
OKD34528Medicare UPIN
OK100014250AMedicaid