Provider Demographics
NPI:1013018795
Name:OPEN MRI OF DURANT,LLC
Entity Type:Organization
Organization Name:OPEN MRI OF DURANT,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SAVAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-504-6156
Mailing Address - Street 1:2911 W UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2978
Mailing Address - Country:US
Mailing Address - Phone:580-924-7030
Mailing Address - Fax:580-924-5448
Practice Address - Street 1:2911 W UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2978
Practice Address - Country:US
Practice Address - Phone:580-924-7030
Practice Address - Fax:580-924-5448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200013350AMedicaid