Organization
SOUTHWEST IMAGING CENTER INC
Active
Organization
SOUTHWEST IMAGING CENTER INC
Active
Other names
THE IMAGING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY LYNN KETCHER (BILLING OFFICE MANAGAER)
(580) 353-7226
Entity
Organization
Contact information
Practice address
5116 W GORE BLVD, STE 1, LAWTON, OK 73505-5909
(580) 353-7226
(580) 353-7297
Mailing address
5116 W GORE BLVD, STE 1, LAWTON, OK 73505-5909
(580) 353-7226
(580) 353-7297
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
700560
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100744930A
—
OK
Enumeration date
05/24/2005
Last updated
08/20/2008
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