Provider Demographics
NPI:1548248206
Name:THOMAS, ROBERT SEAN (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SEAN
Last Name:THOMAS
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 1:4140 W MEMORIAL RD STE 321
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8300
Mailing Address - Country:US
Mailing Address - Phone:405-748-4726
Mailing Address - Fax:405-607-8497
Practice Address - Street 1:2710 S RIFE MEDICAL LN FL 5
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-1452
Practice Address - Country:US
Practice Address - Phone:405-748-4726
Practice Address - Fax:405-607-8497
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4166207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200034140AMedicaid
MO207300609Medicaid
OK200468380XOtherGROUP MEDICAID
OK900522214OtherGROUP MEDICARE
OK330395YKW9Medicare PIN
OK900522214OtherGROUP MEDICARE
OK100747570AMedicaid
P00369555Medicare PIN