MUSKOGEE RADIOLOGICAL GROUP INC NPI 1104882265

NPI Information

NPI: 1104882265
Provider Name: MUSKOGEE RADIOLOGICAL GROUP INC
Classification: Radiology - 2085R0202X
Entity Type: Organization

Specialization: Diagnostic Radiology

Address:
4500 S GARNETT RD
STE 919
TULSA, OK
ZIP 74146
Phone: (918) 728-6145
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MUSKOGEE RADIOLOGICAL GROUP INC is a diagnostic radiology radiology in Tulsa, OK. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. MUSKOGEE RADIOLOGICAL GROUP INC NPI is 1104882265. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4500 S GARNETT RD
STE 919
TULSA, OK
ZIP 74146-229
Phone: (918) 728-6145

The provider's authorized official is Jim Bolene .
The authorized official title is President and has the following contact phone number (918) 728-6145.

The enumeration date for this NPI number is 4/25/2006 and was last updated on 11/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085R0202X	Radiology	Diagnostic Radiology			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	WCDBK1	MEDICARE PIN	OKLAHOMA
2	CO1513	OTHER		RR MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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