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General NPI Number Information
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NPI Number | 1700332129
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Entity Type | Organization
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Legal Business Name | ADVANCED IMAGING RESOURCES CO
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Dates
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Enumeration Date | 08/26/2016
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Last Update Date | 09/06/2016
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Provider Practice Location Address
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Address Line | 4160 SE ADAMS RD #101
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8499
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Country | US
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Telephone | 918-333-9674
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Fax | 918-333-9675
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Provider Business Mailing Address
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Address Line | 4160 SE ADAMS RD #101
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8499
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Country | US
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Telephone | 918-333-9674
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Fax | 918-333-9675
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Authorized Official
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Title or Position | OWNER
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Name | PATRICK D LESTER
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Credential | MD
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Telephone | 918-496-5227
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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