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General NPI Number Information
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NPI Number | 1134432040
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Entity Type | Organization
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Legal Business Name | RADIOLOGY ASSOCIATES OF EASTERN OKLAHOMA PLLC
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Dates
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Enumeration Date | 07/20/2010
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 3330 NW 56TH ST SUITE 206
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4479
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Country | US
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Telephone | 405-945-4710
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Fax | 405-562-9242
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Provider Business Mailing Address
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Address Line | 3330 NW 56TH SUITE 206
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City | OKLAHOMA CITY
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State | OK
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Zip | 73112-4426
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Country | US
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Telephone | 405-945-4710
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Fax | 405-562-9242
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | PAULA J BUTLER
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Credential |
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Telephone | 405-945-4741
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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