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General NPI Number Information
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NPI Number | 1427049956
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Entity Type | Organization
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Legal Business Name | DIAGNOSTIC IMAGING ASSOCIATES INC
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Dates
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Enumeration Date | 11/03/2005
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Last Update Date | 05/18/2021
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Provider Practice Location Address
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Address Line | 744 W 9TH ST
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City | TULSA
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State | OK
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Zip | 74127-9020
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Country | US
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Telephone | 918-935-3550
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Fax | 918-935-3581
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Provider Business Mailing Address
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Address Line | 4500 S GARNETT RD STE 112
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City | TULSA
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State | OK
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Zip | 74146-5201
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Country | US
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Telephone | 918-935-3550
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Fax | 918-935-3581
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. DONALD VON BORSTEL
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Credential | MD
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Telephone | 918-935-3550
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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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