Provider Demographics
NPI:1891886354
Name:MOBILE X-RAY SERVICES INC
Entity Type:Organization
Organization Name:MOBILE X-RAY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:HEHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-282-4647
Mailing Address - Street 1:1209 MOCKINGBIRD LANE
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-2070
Mailing Address - Country:US
Mailing Address - Phone:405-282-4647
Mailing Address - Fax:405-282-1758
Practice Address - Street 1:8200 N CLASSEN BLVD
Practice Address - Street 2:SUITE 123
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-2128
Practice Address - Country:US
Practice Address - Phone:405-826-3370
Practice Address - Fax:405-470-1340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2012-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200004490AMedicaid
OK400522090Medicare ID - Type Unspecified