Healthcare Provider Details

I. General information

NPI: 1124086806
Provider Name (Legal Business Name): OKLAHOMA MEDICAL SPECIALISTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8121 NATIONAL AVE SUITE 150
MIDWEST CITY OK
73110-7530
US

IV. Provider business mailing address

8121 NATIONAL AVE SUITE 300
MIDWEST CITY OK
73110-7530
US

V. Phone/Fax

Practice location:
  • Phone: 405-732-7820
  • Fax: 405-732-7821
Mailing address:
  • Phone: 405-737-9823
  • Fax: 405-733-0779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471M1202X
TaxonomyMagnetic Resonance Imaging Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name: ZAHEER UD-DIN BABER
Title or Position: MEMBER
Credential: M.D.
Phone: 405-737-9823