Healthcare Provider Details

I. General information

NPI: 1891094710
Provider Name (Legal Business Name): PINNACLE HEALTHCARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2011
Last Update Date: 03/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17565 REDBUD LN
MORRIS OK
74445-2354
US

IV. Provider business mailing address

17565 REDBUD LN
MORRIS OK
74445-2354
US

V. Phone/Fax

Practice location:
  • Phone: 918-978-9177
  • Fax:
Mailing address:
  • Phone: 918-978-9177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number22198
License Number StateOK

VIII. Authorized Official

Name: DR. ZACHARIAH ANDERSON
Title or Position: OWNER
Credential: M.D.
Phone: 918-978-9177