# IMG CLINIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851048623
- **Authorized official:** MICHAEL MCMAHAN MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (405) 760-2018

## Contact information

- **Practice address:** 7006 BROADWAY EXTENSION, OKLAHOMA CITY, OK 73116
- **Practice address phone:** (405) 916-4545
- **Mailing address:** 610 W 11TH ST, TRAVERSE CITY, MI 49684-3150
- **Mailing address phone:** (313) 314-0617

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 03/02/2022
- **Last updated:** 03/02/2022