Provider Demographics
NPI:1831843218
Name:OKLAHOMA HEALTHCARE PROVIDER SOLUTIONS, PLLC
Entity type:Organization
Organization Name:OKLAHOMA HEALTHCARE PROVIDER SOLUTIONS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ST JOHN
Authorized Official - Last Name:MAHANEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-942-3737
Mailing Address - Street 1:1116 CAINES HILL RD # 73034
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-2317
Mailing Address - Country:US
Mailing Address - Phone:405-942-3737
Mailing Address - Fax:405-942-3873
Practice Address - Street 1:1116 CAINES HILL RD # 73034
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-2317
Practice Address - Country:US
Practice Address - Phone:405-942-3737
Practice Address - Fax:405-942-3873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-04
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty