Provider Demographics
NPI:1972522845
Name:T.H. MOLSKNESS D.O.
Entity type:Organization
Organization Name:T.H. MOLSKNESS D.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RADIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TILFOLD
Authorized Official - Middle Name:H
Authorized Official - Last Name:MOLSKNESS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-602-8212
Mailing Address - Street 1:11205 GREENBRIAR CHASE ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73170-3218
Mailing Address - Country:US
Mailing Address - Phone:405-691-2785
Mailing Address - Fax:
Practice Address - Street 1:11205 GREENBRIAR CHASE ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73170-3218
Practice Address - Country:US
Practice Address - Phone:405-691-2785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15112085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty