Healthcare Provider Details

I. General information

NPI: 1487837456
Provider Name (Legal Business Name): INTEGRATED MEDICAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2007
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W BRITTON RD
OKLAHOMA CITY OK
73114-3626
US

IV. Provider business mailing address

PO BOX 14740
OKLAHOMA CITY OK
73113-0740
US

V. Phone/Fax

Practice location:
  • Phone: 405-755-8000
  • Fax: 405-755-8001
Mailing address:
  • Phone: 405-755-8000
  • Fax: 405-755-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number10060
License Number StateOK
# 5
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. RONNIE DEAN SOMERVILLE II
Title or Position: OWNER
Credential: DC
Phone: 405-755-8000