Organization
AMERICAN OPEN MRI- ALTUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB MCLAUCHLIN (ADMINISTRATOR)
(405) 210-9020
Entity
Organization
Contact information
Practice address
1116 N MAIN ST, SUITE M12, ALTUS, OK 73521-3149
(580) 477-2674
Mailing address
1116 N MAIN ST, SUITE M12, ALTUS, OK 73521-3149
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OK
Enumeration date
05/10/2006
Last updated
08/22/2020
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