Organization
BC IMAGING LLC FORM KNOWN AS BREAST CARE DIAGNOSTICS LTD. PARTNERSHIP
Active
Other names
Oklahoma Breast Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY K KILLEBREW M.D. (MEDICAL DIRECTOR)
(405) 755-2273
Entity
Organization
Contact information
Practice address
13509 N MERIDIAN AVE, SUITE 6, OKLAHOMA CITY, OK 73120-8396
(405) 755-2273
(405) 751-3505
Mailing address
13509 N MERIDIAN AVE, SUITE 6, OKLAHOMA CITY, OK 73120-8396
(405) 755-2273
(405) 751-3505
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100836670A
—
OK
Enumeration date
04/06/2007
Last updated
01/18/2011
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