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General NPI Number Information
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NPI Number | 1558816850
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Entity Type | Organization
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Legal Business Name | SPECTRUM HEALTHCARE SOLUTIONS, PLLC
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 4220 N CLASSEN BLVD STE A
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City | OKLAHOMA CITY
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State | OK
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Zip | 73118-2434
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Country | US
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Telephone | 405-769-5749
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Fax | 405-493-8506
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Provider Business Mailing Address
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Address Line | PO BOX 6276
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City | NORMAN
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State | OK
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Zip | 73070-6276
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Country | US
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Telephone | 405-768-5749
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Fax | 405-493-8506
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Authorized Official
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Title or Position | COO
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Name | MICHELLE CLARK
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Credential |
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Telephone | 405-768-5749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 26716
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License Number State | OK
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