MEDICARE: INTEGRATED MEDICAL INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1386448181
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTEGRATED MEDICAL INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 14740
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73113-0740
Country	:	US
Telephone Number	:	405-755-8000
Fax Number	:	405-755-8001

Provider Business Practice Location Address
First Line	:	11011 E 41ST ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74146-2714
Country	:	US
Telephone Number	:	918-878-7800
Fax Number	:	405-755-8001

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RONNIE SOMERVILLE
Credential	:
Telephone Number	:	405-755-8000

Provider Enumeration Date	:	04/02/2025
Last Update Date	:	12/22/2025

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