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General NPI Number Information
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NPI Number | 1750577847
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Entity Type | Organization
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Legal Business Name | OPEN DIAGNOSTIC IMAGING LLC
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Dates
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Enumeration Date | 09/21/2007
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Last Update Date | 09/21/2007
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Provider Practice Location Address
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Address Line | 10537 S 92ND EAST CIRCLE
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 918-943-6014
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Fax |
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Provider Business Mailing Address
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Address Line | 8401 JACK FINNEY BLVD
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City | GREENVILLE
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State | TX
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Zip | 75402
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Country | US
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Telephone | 800-945-2455
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Fax | 903-453-2541
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Authorized Official
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Title or Position | CEO
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Name | MR. CRAIG CUNNINGHAM
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Credential |
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Telephone | 214-826-8822
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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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