NPI 1093163024
Thimotee Ilboudo
Practice location
- Address
- 3198 Highway 412 STE B, Colcord, OK 74338-1356
- Phone
- (479) 365-7096
- Mailing address
- 3198 Highway 412 STE B206, Colcord, OK 74338-1356
Registered specialties (2)
Non-emergency Medical Transport (VAN)
Primary
Non-emergency Medical Transport (VAN)
Registry record
- NPI
- 1093163024
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 31 May 2016
- Record last updated
- 4 Jul 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.