MEDICARE: SUBOXONE SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	169034477	OK

General Provider Information

NPI Number	:	1932634789
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUBOXONE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	10813 N. MAC ARTHUR SUITE W
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162
Country	:	US
Telephone Number	:	405-792-2487
Fax Number	:	405-792-2484

Provider Business Practice Location Address
First Line	:	10813 N MACARTHUR BLVD STE W
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73162-6904
Country	:	US
Telephone Number	:	405-792-2486
Fax Number	:	405-792-2484

Authorized Official
Title or Position	:	OWNER
Name	:	EMILY WILSON
Credential	:
Telephone Number	:	405-792-2486

Provider Enumeration Date	:	04/28/2017
Last Update Date	:	04/28/2017

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Directions to “SUBOXONE SOLUTIONS LLC ” Practice Location

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