Organization
MEDICAL PLAZA IMAGING CENTER JOINT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA J BUTLER (BUSINESS MANAGER)
(405) 945-4710
Entity
Organization
Contact information
Practice address
3330 NW 56TH ST, SUITE 206, OKLAHOMA CITY, OK 73112-4479
(405) 945-4710
(405) 945-4751
Mailing address
3330 NW 56TH ST, SUITE 206, OKLAHOMA CITY, OK 73112-4479
(405) 945-4710
(405) 945-4751
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100738500A
—
OK
01
—
CD5554
RAILROAD MEDICARE
OK
Enumeration date
05/12/2006
Last updated
04/04/2014
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