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NPI 1457372492

NPI 1457372492 : OPENSIDED MRI OF OKLAHOMA CITY LLC : OKLAHOMA CITY, OK

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General NPI Number Information
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    NPI Number           |    1457372492
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    Entity Type          |    Organization 
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    Legal Business Name  |    OPENSIDED MRI OF OKLAHOMA CITY LLC 
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Dates
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    Enumeration Date     |    07/23/2006
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    3500 NW 56TH ST ST 105
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    City                 |    OKLAHOMA CITY
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    State                |    OK
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    Zip                  |    73112-4517
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    Country              |    US
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    Telephone            |    405-943-0055
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    Fax                  |    405-943-0078
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Provider Business Mailing Address
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    Address Line         |    3500 NW 56TH ST ST 105
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    City                 |    OKLAHOMA CITY
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    State                |    OK
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    Zip                  |    73112-4517
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    Country              |    US
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    Telephone            |    405-943-0055
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    Fax                  |    405-943-0078
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Authorized Official
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    Title or Position    |    OFFICER TREASURER
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    Name                 |     LINDA  RHODES 
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    Credential           |    
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    Telephone            |    804-217-7114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2471M1202X
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    Taxonomy Name        |    Magnetic Resonance Imaging Radiologic Technologist
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    License Number       |    
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    License Number State |    
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