Organization
PCH RADIOLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD SCOTT ROSENBLUM DO (OWNER)
(321) 698-3724
Entity
Organization
Contact information
Practice address
1900 N 14TH ST, DEPT OF RADIOLOGY, PONCA CITY, OK 74601-2035
(580) 765-0575
(580) 765-0584
Mailing address
200 HANNA DR, PONCA CITY, OK 74604-5764
(321) 698-3724
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APPLYING
BCBSOK
OK
05
—
APPLYING
—
OK
Enumeration date
11/26/2007
Last updated
01/09/2008
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