Small, Tina C

Small, Tina C is an individual health care provider with primary practice located at 4301 Wilson St , Fort Sill OK 73503-4472. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Small, Tina C can be contacted via phone (580) 558-8497.

Contact Information

Primary practice address
4301 Wilson St Fort Sill OK 73503-4472
Fax: (580) 558-3323
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 24054 Oklahoma

Profile Details

NPI number 1720074255
LBN Legal business name Small, Tina C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2005
Last updated Jan 3rd, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720074255 NPPES
Other P00166228 RAILROAD MEDICARE
Other 487023200 RAILROAD MEDICARE
MEDICAID 200038730A RAILROAD MEDICARE
Other 7664685 RAILROAD MEDICARE

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