1558487108 NPI number — OPEN-SIDED MRI OF BARTLESVILLE , LLC

Table of content: DR. MICHAEL ROBERT BEYLER D.C. (NPI 1033255757)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558487108 NPI number — OPEN-SIDED MRI OF BARTLESVILLE , LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPEN-SIDED MRI OF BARTLESVILLE , LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
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Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558487108
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25016
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OKLAHOMA CITY
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
73125-0016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
918-333-9674
Provider Business Mailing Address Fax Number:
918-333-9675

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4160 SE ADAMS RD
Provider Second Line Business Practice Location Address:
BLDG B
Provider Business Practice Location Address City Name:
BARTLESVILLE
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74006-8410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
918-333-9674
Provider Business Practice Location Address Fax Number:
918-333-9675
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TAM
Authorized Official First Name:
WEYTON
Authorized Official Middle Name:
WING-HO
Authorized Official Title or Position:
MANAGING PARTNER
Authorized Official Telephone Number:
918-333-9674

Provider Taxonomy Codes

  • Taxonomy code: 261QM1200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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