Provider Demographics
NPI:1710423785
Name:JTK IMAGING SERVICES LLC
Entity Type:Organization
Organization Name:JTK IMAGING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KIZZIA
Authorized Official - Suffix:
Authorized Official - Credentials:RCS
Authorized Official - Phone:918-616-6396
Mailing Address - Street 1:2413 SAINT ANDREWS CT
Mailing Address - Street 2:
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403-1682
Mailing Address - Country:US
Mailing Address - Phone:918-910-4067
Mailing Address - Fax:918-910-4065
Practice Address - Street 1:2413 SAINT ANDREWS CT
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403-1682
Practice Address - Country:US
Practice Address - Phone:918-910-4067
Practice Address - Fax:918-910-4065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-13
Last Update Date:2017-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335V00000XSuppliersPortable X-ray and/or Other Portable Diagnostic Imaging Supplier