Organization
AREA RADIOLOGICAL CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN L COYNER MD (OWNER)
(972) 526-0342
Entity
Organization
Contact information
Practice address
710 N WALNUT ST, MEDICINE LODGE, KS 67104-1019
(972) 526-0340
(972) 996-1857
Mailing address
PO BOX 2189, PONCA CITY, OK 74602-2189
(972) 526-0340
(972) 996-1857
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100722330A
—
OK
01
—
110166
BLUE CROSS BLUE SHIELD
KS
01
—
CO3641
RAILROAD MEDICARE
—
Enumeration date
03/24/2006
Last updated
04/23/2013
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