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General NPI Number Information
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NPI Number | 1194704494
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Entity Type | Organization
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Legal Business Name | MUSKOGEE PET AND NUCLEAR IMAGING
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 3300 CHANDLER RD SUITE #106
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City | MUSKOGEE
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State | OK
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Zip | 74403-4909
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Country | US
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Telephone | 918-686-7382
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Fax | 918-686-7995
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Provider Business Mailing Address
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Address Line | 3300 CHANDLER RD SUITE #106
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City | MUSKOGEE
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State | OK
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Zip | 74403-4909
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Country | US
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Telephone | 918-686-7382
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Fax | 918-686-7995
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. TIMOTHY D ROBISON
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Credential | M.D.
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Telephone | 918-686-7382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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