Provider Demographics
NPI:1942659982
Name:ORTHOPEDIC SOLUTIONS PLLC
Entity Type:Organization
Organization Name:ORTHOPEDIC SOLUTIONS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-513-8326
Mailing Address - Street 1:101 S SAINTS BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3081
Mailing Address - Country:US
Mailing Address - Phone:405-513-8326
Mailing Address - Fax:405-844-1794
Practice Address - Street 1:101 S SAINTS BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3081
Practice Address - Country:US
Practice Address - Phone:405-513-8326
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty