Breast Imaging of Oklahoma, LLC

NPI #1588734925 in Edmond, Oklahoma

Provider Information

NPI Number: 1588734925
Entity Type: Organization
Organization Name: Breast Imaging of Oklahoma, LLC
Primary Specialty: Specialist
Enumeration Date: Nov 9, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 2601 KELLEY POINTE PKWY STE 101
City: Edmond
State: Oklahoma
ZIP Code: 73013-2996
Phone: (405) 705-2712

Authorized Official

Name: MRS. VICKI LYNN WYNN
Title: CONTROLLER
Phone: (405) 705-2712

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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