Basic Information
| Provider Information | |||||||||
| NPI: | 1326575663 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | LINDSEY | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5400 N INDEPENDENCE AVE STE 150 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731125300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4059514360 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4221 S WESTERN AVE STE 2010 | ||||||||
| Address2: | |||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731093445 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4056445120 | ||||||||
| FaxNumber: | 4056445309 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/17/2017 | ||||||||
| LastUpdateDate: | 05/17/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 2699 | OK | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 2699 | 01 | OK | OKLAHOMA BOARD OF MEDICAL LICENSURE AND SUPERVISION | OTHER |