Provider Demographics
NPI:1891094710
Name:PINNACLE HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:PINNACLE HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-978-9177
Mailing Address - Street 1:17565 REDBUD LN
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:OK
Mailing Address - Zip Code:74445-2354
Mailing Address - Country:US
Mailing Address - Phone:918-978-9177
Mailing Address - Fax:
Practice Address - Street 1:17565 REDBUD LN
Practice Address - Street 2:
Practice Address - City:MORRIS
Practice Address - State:OK
Practice Address - Zip Code:74445-2354
Practice Address - Country:US
Practice Address - Phone:918-978-9177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-17
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22198207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty