Provider Demographics
NPI:1720048010
Name:SALYER, THOMAS W (DO)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:W
Last Name:SALYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1302 S LYNN LN
Mailing Address - Street 2:
Mailing Address - City:IDABEL
Mailing Address - State:OK
Mailing Address - Zip Code:74745-6860
Mailing Address - Country:US
Mailing Address - Phone:580-286-3993
Mailing Address - Fax:580-286-3967
Practice Address - Street 1:1302 S LYNN LN
Practice Address - Street 2:
Practice Address - City:IDABEL
Practice Address - State:OK
Practice Address - Zip Code:74745-6860
Practice Address - Country:US
Practice Address - Phone:580-286-3993
Practice Address - Fax:580-286-3967
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3118207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKF60331Medicare UPIN