Healthcare Provider Details
I. General information
NPI: 1134316169
Provider Name (Legal Business Name): NRHS RADIOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/03/2007
Last Update Date: 10/15/2024
Certification Date: 10/15/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3300 HEALTHPLEX PKWY
NORMAN OK
73072-9749
US
IV. Provider business mailing address
3300 HEALTHPLEX PKWY
NORMAN OK
73072-9749
US
V. Phone/Fax
- Phone: 405-307-1600
- Fax: 405-307-1604
- Phone: 405-307-1600
- Fax: 405-307-1604
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
D
WAGNER
Title or Position: CO-CEO
Credential:
Phone: 405-515-1000