Organization
PK XRAY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIPS LEE KIZZIA (PRESIDENT)
(918) 683-9729
Entity
Organization
Contact information
Practice address
3379A GREEN ACRES RD, SPRINGDALE, AR 72764-0236
(918) 683-9729
(918) 683-1012
Mailing address
347 S 37TH ST, MUSKOGEE, OK 74401-4906
(918) 683-9729
(918) 683-1012
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
RT1299
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165224710
—
AR
Enumeration date
11/07/2007
Last updated
11/24/2008
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