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Grand Lake Imaging Pc
Diagnostic Radiology Physician in Grove, Oklahoma
NPI 1184684011

Grand Lake Imaging Pc is a Diagnostic Radiology Physician based in Indianapolis, OK and is specialized in Diagnostic Radiology. Grand Lake Imaging Pc practices in Grove, OK. The NPI Number for Grand Lake Imaging Pc is 1184684011 and holds a License No. (Oklahoma).

The current practice location address for Grand Lake Imaging Pc is 1001 E 18Th St, Grove, OK and can be reached out via phone at 918-221-7506.

Location: 1001 E 18Th St, Grove, OK, 46206-2264
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1184684011
Provider Name
Grand Lake Imaging Pc
Credential
Provider Entity Type
Organization
Address
1001 E 18Th St, Grove, OK, 46206-2264
Phone Number
918-221-7506
Fax Number
Provider Enumeration Date
03/24/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
DN4636 01 RAILROAD MEDICARE
100748880A 05 OK
institution
Provider Business Practice Location Address Details
Address
1001 E 18Th St
City
Grove
State
Oklahoma
Zip
74344-2907
Phone Number
918-221-7506
Fax Number
person
Provider Business Mailing Address Details
Address
1001 E 18Th St
City
Grove
State
Oklahoma
Zip
74344-2907
Phone Number
918-221-7506
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
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Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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