Organization
SHAWNEE MRI ASSOCIATES, L.L.C.
Active
Other names
Shawnee Open MRI
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL WAYNE WICKERSHAM (VP OF OPERATIONS)
(405) 418-2200
Entity
Organization
Contact information
Practice address
3700 N KICKAPOO AVE, SUITE 116, SHAWNEE, OK 74804-1707
(405) 275-6747
(405) 275-6749
Mailing address
3700 N KICKAPOO AVE, SUITE 116, SHAWNEE, OK 74804-1707
(405) 275-6747
(405) 275-6749
Taxonomy
Speciality
Code
Description
License number
State
261QM1200X
Magnetic Resonance Imaging (MRI) Clinic/Center
Primary
—
OK
Other
Enumeration date
06/20/2006
Last updated
08/22/2020
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