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Classification
Radiology
Type
Diagnostic Radiology
Specialization
Diagnostic Radiology
License No.
15635
License State
OK
Certified
Location

Additional Identifiers

Medical School
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduation Year
1981
Identifier
Type
State
Identifier: 300129676
Type: OTHER (01)
State: OK
Identifier: RADICT107
Type: MEDICARE ID-TYPE UNSPECIFIED (04)
State: OK
Identifier: E28976
Type: MEDICARE UPIN (02)
State: OK
Identifier: 100112790A
Type: MEDICAID (05)
State: OK
Identifier: $$$$$$$$$M
Type: OTHER (01)
State: OK
Identifier: 300019098
Type: OTHER (01)
State: OK

Hospital & Clinics

Business Name
Company Size
Revenue
Business Address
5801 E 41ST ST STE 900, TULSA, OK, 741355631
Business Phone
918-743-8838
Mailing Address
PO BOX 4930, TULSA, OK, 741590930
Mailing Phone
918-747-4975
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