| Resolution Wound Care | |
|
4880 S Lewis Ave Ste 100 Tulsa OK 74105-5178 | |
| (918) 852-6861 | |
| Not Available |
| Full Name | Resolution Wound Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 4880 S Lewis Ave Ste 100, Tulsa, Oklahoma |
| Authorized Official Name and Position | Josh Moushon (CEO) |
| Authorized Official Contact | 9188526861 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resolution Wound Care 4880 S Lewis Ave Ste 100 Tulsa OK 74105-5178 Ph: (918) 852-6861 | Resolution Wound Care 4880 S Lewis Ave Ste 100 Tulsa OK 74105-5178 Ph: (918) 852-6861 |
| NPI Number | 1568260958 |
|---|---|
| Provider Enumeration Date | 03/03/2025 |
| Last Update Date | 03/04/2025 |
| Certification Date | 03/04/2025 |
| Medicare PECOS PAC ID | 1254857337 |
|---|---|
| Medicare Enrollment ID | O20250501001960 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568260958 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 363L00000X | Nurse Practitioner | () | Secondary |
| Provider Name | Tanya L Pond |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356667265 PECOS PAC ID: 4789818758 Enrollment ID: I20131004000405 |
| Provider Name | Joshua Adam Moushon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487035770 PECOS PAC ID: 4183938814 Enrollment ID: I20150807014996 |
| Provider Name | Ashley R Yuras |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962894253 PECOS PAC ID: 0648579896 Enrollment ID: I20160422000756 |
| Provider Name | Megan Kendall Burnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790225688 PECOS PAC ID: 8224306550 Enrollment ID: I20170609001525 |
| Provider Name | Amanda Rain Behar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992320311 PECOS PAC ID: 1951724269 Enrollment ID: I20200706000562 |
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