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General NPI Number Information
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NPI Number | 1902850993
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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 | 05/22/2006
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Last Update Date | 11/14/2013
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Provider Practice Location Address
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Address Line | 13616 E 103RD ST N SUITE C
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City | OWASSO
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State | OK
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Zip | 74055-4586
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Country | US
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Telephone | 918-496-5264
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100 DEPT 401
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City | BIXBY
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State | OK
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Zip | 74008-0100
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Country | US
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Telephone | 918-293-1752
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Fax |
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Authorized Official
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Title or Position | VP BUSINESS SERVICES
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Name | SETH CARNEY
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Credential |
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Telephone | 918-496-5264
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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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