Organization
SOUTH TULSA PET, L.L.C.
Active
Other names
Imaging Solutions of Tulsa
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY WAYNE WICKERSHAM (VP OF OPERATIONS)
(405) 418-2200
Entity
Organization
Contact information
Practice address
7712 S YALE AVE, SUITE 100, TULSA, OK 74136-8332
(918) 523-7226
(918) 523-7227
Mailing address
7712 S YALE AVE, SUITE 100, TULSA, OK 74136-8332
(918) 523-7226
(918) 523-7227
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
OK
Other
Enumeration date
07/17/2006
Last updated
08/22/2020
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