Provider Demographics
NPI:1568918936
Name:ADVANCED IMAGING RESOURCES CO
Entity Type:Organization
Organization Name:ADVANCED IMAGING RESOURCES CO
Other - Org Name:SERVANT MEDICAL IMAGING OF MIDWEST CITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:D
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-496-5227
Mailing Address - Street 1:2300 S DOUGLAS BLVD
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-7114
Mailing Address - Country:US
Mailing Address - Phone:405-736-9222
Mailing Address - Fax:405-736-9144
Practice Address - Street 1:2300 S DOUGLAS BLVD
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-7114
Practice Address - Country:US
Practice Address - Phone:405-736-9222
Practice Address - Fax:405-736-9144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology