Provider Demographics
NPI:1972126357
Name:ELOCIN PSYCHIATRIC SERVICES, PLLC
Entity type:Organization
Organization Name:ELOCIN PSYCHIATRIC SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICEER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:B
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-994-2347
Mailing Address - Street 1:7633 E 63RD PL STE 300
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1202
Mailing Address - Country:US
Mailing Address - Phone:918-994-2347
Mailing Address - Fax:918-856-6082
Practice Address - Street 1:7633 E 63RD PL STE 300
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1202
Practice Address - Country:US
Practice Address - Phone:918-994-2347
Practice Address - Fax:918-856-6082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty