Southwest Imaging Center Inc

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

700560 Issued in OK

Legal business name

SOUTHWEST IMAGING CENTER INC

Practice address

5116 W Gore Blvd
Ste 1
Lawton, OK 73505-5909

Phone

(580) 353-7226

Fax

(580) 353-7297

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kimberly Lynn Ketcher

Title

Billing Office Managaer

Phone

(580) 353-7226

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• THE IMAGING CENTER Former legal business name

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1285637017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 W GORE BLVD",
            "address_2": "STE 1",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055909",
            "telephone_number": "580-353-7226",
            "fax_number": "580-353-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 W GORE BLVD",
            "address_2": "STE 1",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735055909",
            "telephone_number": "580-353-7226",
            "fax_number": "580-353-7297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST IMAGING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "KETCHER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING OFFICE MANAGAER",
        "authorized_official_telephone_number": "580-353-7226",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OK",
            "license": "700560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100744930A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE IMAGING CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Diagnostic Radiology Physician in Lawton, OK
• Providers in Lawton, OK by specialty
• Diagnostic Radiology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2008; 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.