Provider Demographics
NPI:1568260958
Name:RESOLUTION WOUND CARE
Entity type:Organization
Organization Name:RESOLUTION WOUND CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUSHON
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:918-852-6861
Mailing Address - Street 1:4880 S LEWIS AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-5178
Mailing Address - Country:US
Mailing Address - Phone:918-852-6861
Mailing Address - Fax:
Practice Address - Street 1:4880 S LEWIS AVE STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5178
Practice Address - Country:US
Practice Address - Phone:918-852-6861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty