Healthcare Provider Details

I. General information

NPI: 1790053536
Provider Name (Legal Business Name): MMS DIAGNOSTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2011
Last Update Date: 12/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2410 W MEMORIAL RD SUITE C 156
OKLAHOMA CITY OK
73134-8047
US

IV. Provider business mailing address

2410 W MEMORIAL RD SUITE C 156
OKLAHOMA CITY OK
73134-8047
US

V. Phone/Fax

Practice location:
  • Phone: 405-292-9729
  • Fax: 405-286-2613
Mailing address:
  • Phone: 405-292-9729
  • Fax: 405-286-2613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0208X
TaxonomyMobile Radiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. JOHN MURGAI
Title or Position: OWNER
Credential:
Phone: 405-292-9729