Provider Demographics
NPI:1558323030
Name:PALOMINO, VICTOR (DO)
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:PALOMINO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2431 E 61ST ST STE 500
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-1208
Mailing Address - Country:US
Mailing Address - Phone:918-582-6800
Mailing Address - Fax:918-582-6060
Practice Address - Street 1:512 N FRANKLIN ST STE 200
Practice Address - Street 2:
Practice Address - City:JENKS
Practice Address - State:OK
Practice Address - Zip Code:74037-2490
Practice Address - Country:US
Practice Address - Phone:918-582-6800
Practice Address - Fax:918-582-6060
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK4164207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200031910AMedicaid
OK200031910AMedicaid
OKI07880Medicare UPIN