| NPI | 1609614411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA KAY OVERFIELD Credentialing Admin 918-561-5714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology Diagnostic Radiology |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2024-07-16 |
| Last Update Date | 2024-07-16 |