Healthcare Provider Details

I. General information

NPI: 1386448181
Provider Name (Legal Business Name): INTEGRATED MEDICAL INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2025
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11011 E 41ST ST
TULSA OK
74146-2714
US

IV. Provider business mailing address

PO BOX 14740
OKLAHOMA CITY OK
73113-0740
US

V. Phone/Fax

Practice location:
  • Phone: 918-878-7800
  • Fax: 405-755-8001
Mailing address:
  • Phone: 405-755-8000
  • Fax: 405-755-8001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RONNIE SOMERVILLE
Title or Position: PRESIDENT
Credential:
Phone: 405-755-8000