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General NPI Number Information
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NPI Number | 1144471129
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Entity Type | Organization
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Legal Business Name | INTEGRATIVE MEDICAL SOLUTIONS PLLC
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Dates
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Enumeration Date | 10/08/2008
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Last Update Date | 09/11/2015
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Provider Practice Location Address
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Address Line | 65 S SAINTS BLVD
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City | EDMOND
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State | OK
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Zip | 73034-3051
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Country | US
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Telephone | 405-348-2323
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Fax | 405-348-2325
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Provider Business Mailing Address
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Address Line | PO BOX 269084
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-9084
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Country | US
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Telephone | 405-348-2323
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Fax | 405-348-2325
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | WENDY PARKS
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Credential | A.R.N.P
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Telephone | 405-608-0443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | OK
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