SOUTHEAST IMAGING LLC NPI 1902328727

NPI Information

NPI: 1902328727
Provider Name: SOUTHEAST IMAGING, LLC
Classification: Clinic/Center - 261QR0200X
Entity Type: Organization

Specialization: Radiology

CLIA Number: 37D2147401

Address:
111 FOREST AVE.
SUITE C
EUFAULA, OK
ZIP 74432
Phone: (405) 945-4710
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SOUTHEAST IMAGING, LLC is a radiology clinic center in Eufaula, OK. SOUTHEAST IMAGING, LLC NPI is 1902328727. The provider is registered as an organization entity type.

The provider's business location address is:

111 FOREST AVE.
SUITE C
EUFAULA, OK
ZIP 74432
Phone: (405) 945-4710
Fax: (405) 945-4751

The provider's authorized official is Jeremiah Aaron Jansen .
The authorized official title is Member and has the following contact phone number (405) 249-7672.

The CLIA number assigned to this NPI record is 37D2147401 - other - urgent care with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/13/2017 and was last updated on 11/27/2017.

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	261QR0200X	Clinic/Center	Radiology		OKLAHOMA	Yes
2	293D00000X	Physiological Laboratory				No

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: 5/5/2024

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