Basic Information
| Provider Information | |||||||||
| NPI: | 1104009299 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SOLUTIONS PRACTICE MANAGEMENT | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 2210 DUNCAN REGIONAL LOOP RD | ||||||||
| Address2: | |||||||||
| City: | DUNCAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735331564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802518212 | ||||||||
| FaxNumber: | 5802518842 | ||||||||
| Practice Location | |||||||||
| Address1: | 2210 DUNCAN REGIONAL LOOP RD | ||||||||
| Address2: | |||||||||
| City: | DUNCAN | ||||||||
| State: | OK | ||||||||
| PostalCode: | 735331564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5802518212 | ||||||||
| FaxNumber: | 5802518842 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2007 | ||||||||
| LastUpdateDate: | 03/04/2011 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | VOLINSKI | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO/VP | ||||||||
| AuthorizedOfficialTelephone: | 5802518555 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 200135190A | 05 | OK | MEDICAID | 200135190B | 05 | OK | MEDICAID | 200135670A | 05 | OK | MEDICAID |