Broken Arrow Diagnostic Medicine, Pllc

NPI #1710322672 in Broken Arrow, Oklahoma

Provider Information

NPI Number
1710322672
Entity Type
Organization
Organization Name
Broken Arrow Diagnostic Medicine, Pllc
Primary Specialty
Family Medicine
Enumeration Date
May 6, 2013
Last Updated
Oct 8, 2024

Practice Location

Address
5050 E KENOSHA ST
ZIP Code
74014-6711
Phone
(918) 994-5140

Authorized Official

Name
JACOB LEON CALLISON, PA
Title
MANAGING MEMBER
Phone
(918) 994-5140

Specialties & Taxonomy Codes

Specialty
Family Medicine

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