IndividualActive
Thimotee Ilboudo
NPI 1093163024 · Non-emergency Medical Transport (VAN) · Colcord, OK
Provider details
- NPI number
- 1093163024
- Entity type
- Individual
- Primary specialty
- Non-emergency Medical Transport (VAN)Transportation Services
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Transportation Services
- Non-emergency Medical Transport (VAN)343900000X
Transportation Services
Practice location
3198 Highway 412 Ste B
Colcord, OK 74338-1356
Phone: (479) 365-7096
Approximate (ZIP-level) locationGet directions
Mailing address
3198 Highway 412 Ste B206
Colcord, OK 74338-1356
Registry dates
- Enumerated
- 2016-05-31
- Last updated
- 2022-07-04
- Certified
- 2022-07-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.