NPI Code Details Logo

NPI 1376484527

NPI 1376484527 : PATRIOTMED OF KANSAS : TULSA, OK

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1376484527
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    PATRIOTMED OF KANSAS 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    04/02/2026
-----------------------------------------------------
    Last Update Date     |    04/02/2026
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    2424 E 21ST ST STE 425 
-----------------------------------------------------
    City                 |    TULSA
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    74114-1727
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    918-779-7582
-----------------------------------------------------
    Fax                  |    918-779-7587
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2424 E 21ST ST STE 425 
-----------------------------------------------------
    City                 |    TULSA
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    74114-1727
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    918-779-7582
-----------------------------------------------------
    Fax                  |    918-779-7587
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CHIEF STRATEGY OFFICER
-----------------------------------------------------
    Name                 |     ROBERT SCOTT THORNOCK 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    480-369-1270
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QR0200X
-----------------------------------------------------
    Taxonomy Name        |    Radiology Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.