Organization
ELITE WOUND CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARNELL E. BLACKMON MD (OWNER)
(918) 830-0059
Entity
Organization
Contact information
Practice address
8660 E 103RD ST, TULSA, OK 74133-6982
(918) 970-6194
(918) 970-6194
Mailing address
8660 E 103RD ST, TULSA, OK 74133-6982
(918) 830-0059
(918) 970-6194
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
04/12/2022
Last updated
09/24/2022
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