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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