Healthcare Provider Details

I. General information

NPI: 1861150211
Provider Name (Legal Business Name): TRANSITIONAL CARE ORGANIZATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2021
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4220 N CLASSEN BLVD STE D
OKLAHOMA CITY OK
73118-2434
US

IV. Provider business mailing address

4220 N CLASSEN BLVD STE D
OKLAHOMA CITY OK
73118-2434
US

V. Phone/Fax

Practice location:
  • Phone: 405-768-5749
  • Fax:
Mailing address:
  • Phone: 405-768-5749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE CLARK
Title or Position: COO
Credential:
Phone: 405-768-5749