Provider Demographics
NPI:1427572833
Name:OU MEDICINE INC.
Entity Type:Organization
Organization Name:OU MEDICINE INC.
Other - Org Name:MOBILE MAMMOGRAPHY
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:WATSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-271-5100
Mailing Address - Street 1:1200 EVERETT DR
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5047
Mailing Address - Country:US
Mailing Address - Phone:405-271-5100
Mailing Address - Fax:405-271-6753
Practice Address - Street 1:13401 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73142-9109
Practice Address - Country:US
Practice Address - Phone:405-755-2273
Practice Address - Fax:405-507-1314
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OU MEDICINE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-27
Last Update Date:2017-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0207XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mobile Mammography