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Organization
IMG CLINIC PLLC
Active
Organization
IMG CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MCMAHAN MD (MEDICAL DIRECTOR)
(405) 760-2018
Entity
Organization
Contact information
Practice address
7006 BROADWAY EXTENSION, OKLAHOMA CITY, OK 73116
(405) 916-4545
Mailing address
610 W 11TH ST, TRAVERSE CITY, MI 49684-3150
(313) 314-0617
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/02/2022
Last updated
03/02/2022
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