Provider Demographics
NPI:1922330927
Name:ALTERNATIVE PAIN CARE, P.C.
Entity Type:Organization
Organization Name:ALTERNATIVE PAIN CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WELDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-744-5959
Mailing Address - Street 1:2325 S HARVARD AVE
Mailing Address - Street 2:SUITE 308
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3300
Mailing Address - Country:US
Mailing Address - Phone:918-744-5959
Mailing Address - Fax:918-742-4412
Practice Address - Street 1:2325 S HARVARD AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-744-5959
Practice Address - Fax:918-742-4412
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-02
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15263207R00000X
OK15236208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKC95637Medicare UPIN
OK1114123619Medicare PIN