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General NPI Number Information
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NPI Number | 1497927768
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Entity Type | Organization
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Legal Business Name | PHYSICIANS OPEN MRI LLC
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Dates
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Enumeration Date | 03/27/2008
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 620 QUINTARD DR
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City | OXFORD
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State | AL
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Zip | 36203-1840
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Country | US
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Telephone | 256-737-9828
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Fax | 256-739-5893
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Provider Business Mailing Address
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Address Line | PO BOX 117
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City | CULLMAN
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State | AL
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Zip | 35056-0117
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Country | US
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Telephone | 256-737-9828
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Fax | 256-739-5893
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MR. STEPHEN P BYRUM
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Credential |
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Telephone | 256-737-9828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State |
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