Basic Information
Provider Information
NPI: 1861673493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOLIN
FirstName: ELIZABETH
MiddleName: KAY
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1515 N HARVARD AVE
Address2: STE E
City: TULSA
State: OK
PostalCode: 741154957
CountryCode: US
TelephoneNumber: 9188326049
FaxNumber: 9188326055
Practice Location
Address1: 1725 E 19TH ST
Address2: SUITE 200
City: TULSA
State: OK
PostalCode: 741045437
CountryCode: US
TelephoneNumber: 9187488381
FaxNumber: 9187488397
Other Information
ProviderEnumerationDate: 11/26/2007
LastUpdateDate: 06/17/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XM0057TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0200XM0057TXN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001XM0057TXN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RS0012XM0057TXN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207RC0200X4064OKN Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207R00000X4064OKN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001X4064OKY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RS0012X4064OKN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine

No ID Information.


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