SOUTHERN OKLAHOMA DIAGNOSTIC CENTER, LLC (NPI# 1114021284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114021284 |
| Entity Type | Organization |
| Organization Name | SOUTHERN OKLAHOMA DIAGNOSTIC CENTER, LLC |
| Other Organization Name | OPEN MRI OF SOUTHERN OKLAHOMA |
| Practice Address |
1111 Walnut Ardmore OK 73401 |
| Mailing Address |
1111 Walnut Dr Ardmore OK 73401-2354 |
| Practice Telephone | 5802261674 |
| Practice Fax Number | 5802269674 |
| Mailing Telephone | 5802261674 |
| Mailing Fax Number | 5802269674 |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2013-01-16 |
| Authorized Official Name | HAYDEN D HENRY (BOARD PRESIDENT) |
| Authorized Official Telephone | 5802268310 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1200X |
Clinic/Center Specialization: Magnetic Resonance Imaging (MRI) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Open MRI of Southern Oklahoma | Doing Business As Name - Organization |
| Street Address |
1111 WALNUT |
| City | ARDMORE |
| State | OK |
| Zip Code | 73401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497391452 | Abbie Deeann Mclemore | Nurse Practitioner | 915 10th Ave, Ardmore, OK 73401 | 2019-11-25 |
| 1790349991 | Shirley Denise Brown | Licensed Psychiatric Technician | 1219 Kst N.w, 1219 Kst N.w, Ardmore, OK 73401 | 2019-04-24 |
| 1427512359 | Billy Joe Oshields | Case Manager/Care Coordinator | 6862 State Hwy 199 Ardmore Oklahoma, 6862 State Hwy 199, Ardmore, OK 73401 | 2019-01-24 |
| 1174007595 | Tawnya Dawn Peery | Nurse Practitioner | 1108 W. Walnut Drive, Ardmore, OK 73401 | 2018-09-21 |
| 1679055016 | Teresa Marie Hernandez | Behavior Technician | 1219 K St. Nw, Ardmore, OK 73401 | 2018-09-01 |
| 1063991974 | Sawyer Rae Shamburger | Occupational Therapy Assistant | 208 North Praire St, Pilot Point, TX 73401 | 2018-08-10 |
| 1417473521 | Chelsye Bacon | Peer Specialist | 905 Holiday Drive, Ardmore, OK 73401 | 2017-08-21 |
| 1003279746 | Jeni Presley | Marriage & Family Therapist | Outpatient Services-ardmore; 2510 Chickasaw Dr., Strong Family Development;, Ardmore, OK 73401 | 2016-03-31 |
| 1982080909 | Alison Hill | Pharmacist | 1111 N. Commerce, Ardmore, OK 73401 | 2015-07-31 |
| 1316346547 | Olivia Larae Carrell | Counselor | 15 Monroe Street Ne, Ardmore, OK 73401 | 2014-08-13 |
| Find all providers in zip 73401 | ||||
| Taxonomy Code | 261QM1200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Magnetic Resonance Imaging (MRI) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932711710 | Tulsa Radiology and Imaging Center LLC | Clinic/Center | 5711 E 71st St Ste 100d, Tulsa, OK 74136-6655 | 2020-08-21 |
| 1114193174 | Rudy S Fernandez Md PC | Clinic/Center | 1023 Waterwood Pkwy, Edmond, OK 73034-5324 | 2008-04-30 |
| 1538345244 | Liberty Diagnostic Imaging of Okc LLC | Clinic/Center | 4001 Nw Expressway St, Oklahoma City, OK 73116-1686 | 2008-01-11 |
| 1558487108 | Open-sided Mri of Bartlesville, LLC | Clinic/Center | 4160 Se Adams Rd, Bldg B, Bartlesville, OK 74006-8410 | 2007-03-22 |
| 1184797185 | Advantage Diagnositc & Mri, LLC | Clinic/Center | 9149 S Yale Ave # 305, Tulsa, OK 74137-4024 | 2006-11-16 |
| 1013018795 | Open Mri of Durant,llc | Clinic/Center | 2911 W University Blvd, Durant, OK 74701-2978 | 2006-09-26 |
| 1922023175 | Shiloh Imaging Center LLC | Clinic/Center | 1415 N Watts St, Sayre, OK 73662-1310 | 2006-07-12 |
| 1942239702 | Vantage Open Mri LLC | Clinic/Center | 3400 W Hefner Rd, Oklahoma City, OK 73120-5083 | 2006-07-02 |
| 1922044841 | Ada Mri Associates, L.L.C. | Clinic/Center | 435 N Monte Vista St, Suite B, Ada, OK 74820-4609 | 2006-06-20 |
| 1689611303 | Midwest Open Mri, LLC | Clinic/Center | 2300 S Douglas Blvd, Midwest City, OK 73130-7114 | 2006-06-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on SOUTHERN OKLAHOMA DIAGNOSTIC CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.