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General NPI Number Information
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NPI Number | 1053302380
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Entity Type | Organization
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Legal Business Name | SOUTHERN OKLAHOMA PET IMAGING LLC
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Dates
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Enumeration Date | 11/04/2005
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Last Update Date | 04/28/2008
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Provider Practice Location Address
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Address Line | 701 E ROBINSON ST SUITE 102
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City | NORMAN
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State | OK
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Zip | 73071-6625
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Country | US
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Telephone | 405-928-2900
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1509
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City | NORMAN
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State | OK
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Zip | 73070-1509
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JOSIE FRANTZ
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Credential |
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Telephone | 405-321-8125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0904X
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Taxonomy Name | Nuclear Radiology Physician
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License Number |
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License Number State |
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