Organization Active NPI

Radiology Associates of Eastern Oklahoma PLLC

  • Diagnostic Radiology Physician
  • Oklahoma City, OK
National Provider Identifier
1134432040
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
RADIOLOGY ASSOCIATES OF EASTERN OKLAHOMA PLLC
Practice address
3330 NW 56TH St
Suite 206
Oklahoma City, OK 73112-4479
Phone
(405) 945-4710
Fax
(405) 562-9242
NPI assigned
Jul 20, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Paula J Butler
Title
Business Manager
Phone
(405) 945-4741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

3330 NW 56TH St
Suite 206
Oklahoma City, OK 73112-4479

Mailing address

3330 NW 56TH
Suite 206
Oklahoma City, OK 73112-4426
Phone (405) 945-4710

Other identifiers 2

IdentifierTypeStateIssuer
200332530AMedicaidOK
DR7722OtherOKMEDICARE RAILROAD

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

111 W Forrest Ave
Ste C
Eufaula, OK 74432
Phone (918) 490-7011

Dept 960593
Oklahoma City, OK 73196

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1279584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318550400000",
    "number": "1134432040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124426",
            "telephone_number": "405-945-4710",
            "fax_number": "405-562-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 NW 56TH ST",
            "address_2": "SUITE 206",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124479",
            "telephone_number": "405-945-4710",
            "fax_number": "405-562-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RADIOLOGY ASSOCIATES OF EASTERN OKLAHOMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-20",
        "last_updated": "2011-10-14",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "405-945-4741"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200332530A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DR7722",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.