Healthcare Provider Details

I. General information

NPI: 1528011681
Provider Name (Legal Business Name): E PLUS PET IMAGING IV LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 06/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 HARRISON AVE SUITE 104
OKLAHOMA CITY OK
73104-1817
US

IV. Provider business mailing address

111 HARRISON AVE SUITE 104
OKLAHOMA CITY OK
73104-1817
US

V. Phone/Fax

Practice location:
  • Phone: 405-272-5090
  • Fax: 405-272-5091
Mailing address:
  • Phone: 405-272-5090
  • Fax: 405-272-5091

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROBERT RHYMER
Title or Position: COO OF GENERAL PARTNER
Credential:
Phone: 615-467-7415