Provider Demographics
NPI:1780636142
Name:NORMAN IMAGING ASSOCIATES, LLC
Entity Type:Organization
Organization Name:NORMAN IMAGING ASSOCIATES, LLC
Other - Org Name:BROOKHAVEN DIAGNOSTIC IMAGING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-796-7226
Mailing Address - Street 1:3750 W. ROBINSON
Mailing Address - Street 2:#130
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072
Mailing Address - Country:US
Mailing Address - Phone:405-796-7226
Mailing Address - Fax:
Practice Address - Street 1:3750 W ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3654
Practice Address - Country:US
Practice Address - Phone:405-796-7226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology