| NPI | 1023067857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW G. POWERS Physician 918-748-4378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2085N0700X Radiology Neuroradiology |
| 2085R0204X Radiology Vascular & Interventional Radiology | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2014-04-29 |