MEDICARE: PERIGON IMAGING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085D0003X	Diagnostic Neuroimaging (Radiology) Physician
2	261QR0200X	Radiology Clinic/Center

General Provider Information

NPI Number	:	1023680790
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERIGON IMAGING LLC

Provider Business Mailing Address
First Line	:	PO BOX 18484
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73154-0484
Country	:	US
Telephone Number	:	405-418-2200
Fax Number	:	405-418-2901

Provider Business Practice Location Address
First Line	:	8224 SILVER CROSSING
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3375
Country	:	US
Telephone Number	:	405-418-2900
Fax Number	:	405-418-2901

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. JOHN R FRAME
Credential	:	M.D.
Telephone Number	:	918-640-7797

Provider Enumeration Date	:	07/13/2021
Last Update Date	:	04/18/2024

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Directions to “PERIGON IMAGING LLC ” Practice Location

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