Provider Demographics
NPI:1033436910
Name:PHILP, TOM
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:PHILP
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:STONEBRIDGE
Other - Middle Name:FAMILY
Other - Last Name:THERAPY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1201 E 33RD ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-2017
Mailing Address - Country:US
Mailing Address - Phone:918-398-7678
Mailing Address - Fax:
Practice Address - Street 1:1201 E 33RD ST
Practice Address - Street 2:SUITE B
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-2017
Practice Address - Country:US
Practice Address - Phone:918-398-7678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-30
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional